Specificity for each of the 46 criteria of the Selvester QRS score for electrocardiographic myocardial scar sizing in left bundle branch block
Abstract Background The Selvester QRS score consists of a set of electrocardiographic criteria designed to identify, quantify and localize scar in the left ventricle using the morphology of the QRS complex. These criteria were updated in 2009 to expand their use to patients with underlying conductio...
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| Veröffentlicht in: | Journal of electrocardiology 2015-09, Vol.48 (5), p.769-776 |
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| creator | Åkerlund, Sofia, MS Wieslander, Björn, MD Turesson, Madeleine, MS Nijveldt, Robin, MD, PhD Klem, Igor, MD Almer, Jakob, MD Engblom, Henrik, MD, PhD Wagner, Galen S., MD Atwater, Brett D., MD Ugander, Martin, MD, PhD |
| description | Abstract Background The Selvester QRS score consists of a set of electrocardiographic criteria designed to identify, quantify and localize scar in the left ventricle using the morphology of the QRS complex. These criteria were updated in 2009 to expand their use to patients with underlying conduction abnormalities, but these versions have thus far only been validated in small and carefully selected populations. Aim To determine the specificity for each of the criteria of the left bundle branch block (LBBB) modified Selvester QRS Score (LB-SS) in a population with strict LBBB and no myocardial scar as verified by cardiovascular magnetic resonance imaging with late gadolinium enhancement (CMR-LGE). Methods We identified ninety-nine patients with LBBB without scar on CMR-LGE, who underwent a clinically indicated CMR scan at three different centers. The ECG recording date was any time prior to or < 30 days after the CMR scan. The LB-SS was applied and specificity for detection of scar in each of the 46 separate criteria was determined. Results The specificity ranged between 41% and 100% for the 46 criteria of LB-SS and 27/46 (59%) met ≥ 95% specificity. The mean ± SD specificity was 90% ± 14%. Conclusion Several of the criteria in the LB-SS lack adequate specificity. Elimination or modification of these nonspecific QRS morphology criteria may improve the specificity of the overall LB-SS. |
| doi_str_mv | 10.1016/j.jelectrocard.2015.07.018 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_swepu</sourceid><recordid>TN_cdi_swepub_primary_oai_swepub_ki_se_511411</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>1_s2_0_S0022073615002186</els_id><sourcerecordid>1712522630</sourcerecordid><originalsourceid>FETCH-LOGICAL-c612t-14d2e394d5ea8f7a3f9f7ec7bcc94ca2cd41325464ff2a8a6c5826d84439f6213</originalsourceid><addsrcrecordid>eNqNUl2L1DAULaK46-pfkOCTLx2TNElbHwTZ9QsGREefQ5rc7GQm09SkXRl_hL_ZlM6uIgg-XHI5nHtOuPcUxTOCVwQT8WK32oEHPcagVTQriglf4XqFSXOvOCe8omXDKny_OMeY0hLXlTgrHqW0wxi3tKYPizMqqOC4rc-Ln5sBtLNOu_GIbIgIlN6iYNG4BcQE0tGNEJ26hTbgbyBlCH36vEFJhwjL2O8PuXAd1bB1Gh2OC6B8ZqqIkvvh-mvkeuTBjqibeuMBdVH12bPzQe8fFw-s8gmenN6L4uvbN18u35frj-8-XL5el1oQOpaEGQpVywwH1dhaVba1Nei607plWlFtGKkoZ4JZS1WjhOYNFaZhrGqtoKS6KMpFN32HYerkEN1BxaMMyskTtM8dSE4IIzN__U--n4ZcXa55oGaaEmVqyQXlkrW4k4ozkEp1lpnaYqNVlnu-yA0xfJvyPuXBJQ3eqx7ClCSpCeWUigpn6suFqmNIKYK98yZYznGQO_lnHOQcB4lrmeOQh5-efKbuAOZu9Pb-mXC1ECAv-8ZBlEk76DUYF7OkNMH9n8-rv2S0d73Tyu_hCGkXptjnc0oiE5VYbuZgzrkkPHekEdUvbj7k1g</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1712522630</pqid></control><display><type>article</type><title>Specificity for each of the 46 criteria of the Selvester QRS score for electrocardiographic myocardial scar sizing in left bundle branch block</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals</source><creator>Åkerlund, Sofia, MS ; Wieslander, Björn, MD ; Turesson, Madeleine, MS ; Nijveldt, Robin, MD, PhD ; Klem, Igor, MD ; Almer, Jakob, MD ; Engblom, Henrik, MD, PhD ; Wagner, Galen S., MD ; Atwater, Brett D., MD ; Ugander, Martin, MD, PhD</creator><creatorcontrib>Åkerlund, Sofia, MS ; Wieslander, Björn, MD ; Turesson, Madeleine, MS ; Nijveldt, Robin, MD, PhD ; Klem, Igor, MD ; Almer, Jakob, MD ; Engblom, Henrik, MD, PhD ; Wagner, Galen S., MD ; Atwater, Brett D., MD ; Ugander, Martin, MD, PhD</creatorcontrib><description>Abstract Background The Selvester QRS score consists of a set of electrocardiographic criteria designed to identify, quantify and localize scar in the left ventricle using the morphology of the QRS complex. These criteria were updated in 2009 to expand their use to patients with underlying conduction abnormalities, but these versions have thus far only been validated in small and carefully selected populations. Aim To determine the specificity for each of the criteria of the left bundle branch block (LBBB) modified Selvester QRS Score (LB-SS) in a population with strict LBBB and no myocardial scar as verified by cardiovascular magnetic resonance imaging with late gadolinium enhancement (CMR-LGE). Methods We identified ninety-nine patients with LBBB without scar on CMR-LGE, who underwent a clinically indicated CMR scan at three different centers. The ECG recording date was any time prior to or < 30 days after the CMR scan. The LB-SS was applied and specificity for detection of scar in each of the 46 separate criteria was determined. Results The specificity ranged between 41% and 100% for the 46 criteria of LB-SS and 27/46 (59%) met ≥ 95% specificity. The mean ± SD specificity was 90% ± 14%. Conclusion Several of the criteria in the LB-SS lack adequate specificity. Elimination or modification of these nonspecific QRS morphology criteria may improve the specificity of the overall LB-SS.</description><identifier>ISSN: 0022-0736</identifier><identifier>ISSN: 1532-8430</identifier><identifier>EISSN: 1532-8430</identifier><identifier>DOI: 10.1016/j.jelectrocard.2015.07.018</identifier><identifier>PMID: 26265097</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Algorithms ; Bundle-Branch Block - classification ; Bundle-Branch Block - complications ; Bundle-Branch Block - diagnosis ; Cardiac and Cardiovascular Systems ; Cardiovascular ; Cicatrix - classification ; Cicatrix - complications ; Cicatrix - diagnosis ; Clinical Medicine ; Diagnosis, Computer-Assisted - methods ; Electrocardiography ; Electrocardiography - methods ; Female ; Humans ; Kardiologi ; Klinisk medicin ; Left bundle branch block ; Male ; Medical and Health Sciences ; Medicin och hälsovetenskap ; Middle Aged ; Myocardial scar ; Myocardial Stunning - classification ; Myocardial Stunning - complications ; Myocardial Stunning - diagnosis ; Observer Variation ; Reproducibility of Results ; Selvester QRS score ; Sensitivity and Specificity ; Severity of Illness Index ; Software Validation ; Specificity</subject><ispartof>Journal of electrocardiology, 2015-09, Vol.48 (5), p.769-776</ispartof><rights>Elsevier Inc.</rights><rights>2015 Elsevier Inc.</rights><rights>Copyright © 2015 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c612t-14d2e394d5ea8f7a3f9f7ec7bcc94ca2cd41325464ff2a8a6c5826d84439f6213</citedby><cites>FETCH-LOGICAL-c612t-14d2e394d5ea8f7a3f9f7ec7bcc94ca2cd41325464ff2a8a6c5826d84439f6213</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jelectrocard.2015.07.018$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>230,314,776,780,881,3536,27903,27904,45974</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26265097$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://lup.lub.lu.se/record/7844201$$DView record from Swedish Publication Index$$Hfree_for_read</backlink><backlink>$$Uhttp://kipublications.ki.se/Default.aspx?queryparsed=id:132153886$$DView record from Swedish Publication Index$$Hfree_for_read</backlink></links><search><creatorcontrib>Åkerlund, Sofia, MS</creatorcontrib><creatorcontrib>Wieslander, Björn, MD</creatorcontrib><creatorcontrib>Turesson, Madeleine, MS</creatorcontrib><creatorcontrib>Nijveldt, Robin, MD, PhD</creatorcontrib><creatorcontrib>Klem, Igor, MD</creatorcontrib><creatorcontrib>Almer, Jakob, MD</creatorcontrib><creatorcontrib>Engblom, Henrik, MD, PhD</creatorcontrib><creatorcontrib>Wagner, Galen S., MD</creatorcontrib><creatorcontrib>Atwater, Brett D., MD</creatorcontrib><creatorcontrib>Ugander, Martin, MD, PhD</creatorcontrib><title>Specificity for each of the 46 criteria of the Selvester QRS score for electrocardiographic myocardial scar sizing in left bundle branch block</title><title>Journal of electrocardiology</title><addtitle>J Electrocardiol</addtitle><description>Abstract Background The Selvester QRS score consists of a set of electrocardiographic criteria designed to identify, quantify and localize scar in the left ventricle using the morphology of the QRS complex. These criteria were updated in 2009 to expand their use to patients with underlying conduction abnormalities, but these versions have thus far only been validated in small and carefully selected populations. Aim To determine the specificity for each of the criteria of the left bundle branch block (LBBB) modified Selvester QRS Score (LB-SS) in a population with strict LBBB and no myocardial scar as verified by cardiovascular magnetic resonance imaging with late gadolinium enhancement (CMR-LGE). Methods We identified ninety-nine patients with LBBB without scar on CMR-LGE, who underwent a clinically indicated CMR scan at three different centers. The ECG recording date was any time prior to or < 30 days after the CMR scan. The LB-SS was applied and specificity for detection of scar in each of the 46 separate criteria was determined. Results The specificity ranged between 41% and 100% for the 46 criteria of LB-SS and 27/46 (59%) met ≥ 95% specificity. The mean ± SD specificity was 90% ± 14%. Conclusion Several of the criteria in the LB-SS lack adequate specificity. Elimination or modification of these nonspecific QRS morphology criteria may improve the specificity of the overall LB-SS.</description><subject>Algorithms</subject><subject>Bundle-Branch Block - classification</subject><subject>Bundle-Branch Block - complications</subject><subject>Bundle-Branch Block - diagnosis</subject><subject>Cardiac and Cardiovascular Systems</subject><subject>Cardiovascular</subject><subject>Cicatrix - classification</subject><subject>Cicatrix - complications</subject><subject>Cicatrix - diagnosis</subject><subject>Clinical Medicine</subject><subject>Diagnosis, Computer-Assisted - methods</subject><subject>Electrocardiography</subject><subject>Electrocardiography - methods</subject><subject>Female</subject><subject>Humans</subject><subject>Kardiologi</subject><subject>Klinisk medicin</subject><subject>Left bundle branch block</subject><subject>Male</subject><subject>Medical and Health Sciences</subject><subject>Medicin och hälsovetenskap</subject><subject>Middle Aged</subject><subject>Myocardial scar</subject><subject>Myocardial Stunning - classification</subject><subject>Myocardial Stunning - complications</subject><subject>Myocardial Stunning - diagnosis</subject><subject>Observer Variation</subject><subject>Reproducibility of Results</subject><subject>Selvester QRS score</subject><subject>Sensitivity and Specificity</subject><subject>Severity of Illness Index</subject><subject>Software Validation</subject><subject>Specificity</subject><issn>0022-0736</issn><issn>1532-8430</issn><issn>1532-8430</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNUl2L1DAULaK46-pfkOCTLx2TNElbHwTZ9QsGREefQ5rc7GQm09SkXRl_hL_ZlM6uIgg-XHI5nHtOuPcUxTOCVwQT8WK32oEHPcagVTQriglf4XqFSXOvOCe8omXDKny_OMeY0hLXlTgrHqW0wxi3tKYPizMqqOC4rc-Ln5sBtLNOu_GIbIgIlN6iYNG4BcQE0tGNEJ26hTbgbyBlCH36vEFJhwjL2O8PuXAd1bB1Gh2OC6B8ZqqIkvvh-mvkeuTBjqibeuMBdVH12bPzQe8fFw-s8gmenN6L4uvbN18u35frj-8-XL5el1oQOpaEGQpVywwH1dhaVba1Nei607plWlFtGKkoZ4JZS1WjhOYNFaZhrGqtoKS6KMpFN32HYerkEN1BxaMMyskTtM8dSE4IIzN__U--n4ZcXa55oGaaEmVqyQXlkrW4k4ozkEp1lpnaYqNVlnu-yA0xfJvyPuXBJQ3eqx7ClCSpCeWUigpn6suFqmNIKYK98yZYznGQO_lnHOQcB4lrmeOQh5-efKbuAOZu9Pb-mXC1ECAv-8ZBlEk76DUYF7OkNMH9n8-rv2S0d73Tyu_hCGkXptjnc0oiE5VYbuZgzrkkPHekEdUvbj7k1g</recordid><startdate>20150901</startdate><enddate>20150901</enddate><creator>Åkerlund, Sofia, MS</creator><creator>Wieslander, Björn, MD</creator><creator>Turesson, Madeleine, MS</creator><creator>Nijveldt, Robin, MD, PhD</creator><creator>Klem, Igor, MD</creator><creator>Almer, Jakob, MD</creator><creator>Engblom, Henrik, MD, PhD</creator><creator>Wagner, Galen S., MD</creator><creator>Atwater, Brett D., MD</creator><creator>Ugander, Martin, MD, PhD</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>ADTPV</scope><scope>AOWAS</scope><scope>D95</scope></search><sort><creationdate>20150901</creationdate><title>Specificity for each of the 46 criteria of the Selvester QRS score for electrocardiographic myocardial scar sizing in left bundle branch block</title><author>Åkerlund, Sofia, MS ; Wieslander, Björn, MD ; Turesson, Madeleine, MS ; Nijveldt, Robin, MD, PhD ; Klem, Igor, MD ; Almer, Jakob, MD ; Engblom, Henrik, MD, PhD ; Wagner, Galen S., MD ; Atwater, Brett D., MD ; Ugander, Martin, MD, PhD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c612t-14d2e394d5ea8f7a3f9f7ec7bcc94ca2cd41325464ff2a8a6c5826d84439f6213</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Algorithms</topic><topic>Bundle-Branch Block - classification</topic><topic>Bundle-Branch Block - complications</topic><topic>Bundle-Branch Block - diagnosis</topic><topic>Cardiac and Cardiovascular Systems</topic><topic>Cardiovascular</topic><topic>Cicatrix - classification</topic><topic>Cicatrix - complications</topic><topic>Cicatrix - diagnosis</topic><topic>Clinical Medicine</topic><topic>Diagnosis, Computer-Assisted - methods</topic><topic>Electrocardiography</topic><topic>Electrocardiography - methods</topic><topic>Female</topic><topic>Humans</topic><topic>Kardiologi</topic><topic>Klinisk medicin</topic><topic>Left bundle branch block</topic><topic>Male</topic><topic>Medical and Health Sciences</topic><topic>Medicin och hälsovetenskap</topic><topic>Middle Aged</topic><topic>Myocardial scar</topic><topic>Myocardial Stunning - classification</topic><topic>Myocardial Stunning - complications</topic><topic>Myocardial Stunning - diagnosis</topic><topic>Observer Variation</topic><topic>Reproducibility of Results</topic><topic>Selvester QRS score</topic><topic>Sensitivity and Specificity</topic><topic>Severity of Illness Index</topic><topic>Software Validation</topic><topic>Specificity</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Åkerlund, Sofia, MS</creatorcontrib><creatorcontrib>Wieslander, Björn, MD</creatorcontrib><creatorcontrib>Turesson, Madeleine, MS</creatorcontrib><creatorcontrib>Nijveldt, Robin, MD, PhD</creatorcontrib><creatorcontrib>Klem, Igor, MD</creatorcontrib><creatorcontrib>Almer, Jakob, MD</creatorcontrib><creatorcontrib>Engblom, Henrik, MD, PhD</creatorcontrib><creatorcontrib>Wagner, Galen S., MD</creatorcontrib><creatorcontrib>Atwater, Brett D., MD</creatorcontrib><creatorcontrib>Ugander, Martin, MD, PhD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>SwePub</collection><collection>SwePub Articles</collection><collection>SWEPUB Lunds universitet</collection><jtitle>Journal of electrocardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Åkerlund, Sofia, MS</au><au>Wieslander, Björn, MD</au><au>Turesson, Madeleine, MS</au><au>Nijveldt, Robin, MD, PhD</au><au>Klem, Igor, MD</au><au>Almer, Jakob, MD</au><au>Engblom, Henrik, MD, PhD</au><au>Wagner, Galen S., MD</au><au>Atwater, Brett D., MD</au><au>Ugander, Martin, MD, PhD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Specificity for each of the 46 criteria of the Selvester QRS score for electrocardiographic myocardial scar sizing in left bundle branch block</atitle><jtitle>Journal of electrocardiology</jtitle><addtitle>J Electrocardiol</addtitle><date>2015-09-01</date><risdate>2015</risdate><volume>48</volume><issue>5</issue><spage>769</spage><epage>776</epage><pages>769-776</pages><issn>0022-0736</issn><issn>1532-8430</issn><eissn>1532-8430</eissn><abstract>Abstract Background The Selvester QRS score consists of a set of electrocardiographic criteria designed to identify, quantify and localize scar in the left ventricle using the morphology of the QRS complex. These criteria were updated in 2009 to expand their use to patients with underlying conduction abnormalities, but these versions have thus far only been validated in small and carefully selected populations. Aim To determine the specificity for each of the criteria of the left bundle branch block (LBBB) modified Selvester QRS Score (LB-SS) in a population with strict LBBB and no myocardial scar as verified by cardiovascular magnetic resonance imaging with late gadolinium enhancement (CMR-LGE). Methods We identified ninety-nine patients with LBBB without scar on CMR-LGE, who underwent a clinically indicated CMR scan at three different centers. The ECG recording date was any time prior to or < 30 days after the CMR scan. The LB-SS was applied and specificity for detection of scar in each of the 46 separate criteria was determined. Results The specificity ranged between 41% and 100% for the 46 criteria of LB-SS and 27/46 (59%) met ≥ 95% specificity. The mean ± SD specificity was 90% ± 14%. Conclusion Several of the criteria in the LB-SS lack adequate specificity. Elimination or modification of these nonspecific QRS morphology criteria may improve the specificity of the overall LB-SS.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>26265097</pmid><doi>10.1016/j.jelectrocard.2015.07.018</doi><tpages>8</tpages></addata></record> |
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| ispartof | Journal of electrocardiology, 2015-09, Vol.48 (5), p.769-776 |
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| subjects | Algorithms Bundle-Branch Block - classification Bundle-Branch Block - complications Bundle-Branch Block - diagnosis Cardiac and Cardiovascular Systems Cardiovascular Cicatrix - classification Cicatrix - complications Cicatrix - diagnosis Clinical Medicine Diagnosis, Computer-Assisted - methods Electrocardiography Electrocardiography - methods Female Humans Kardiologi Klinisk medicin Left bundle branch block Male Medical and Health Sciences Medicin och hälsovetenskap Middle Aged Myocardial scar Myocardial Stunning - classification Myocardial Stunning - complications Myocardial Stunning - diagnosis Observer Variation Reproducibility of Results Selvester QRS score Sensitivity and Specificity Severity of Illness Index Software Validation Specificity |
| title | Specificity for each of the 46 criteria of the Selvester QRS score for electrocardiographic myocardial scar sizing in left bundle branch block |
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