The value of the QRS scoring system in assessing regional and global left ventricular ejection fraction early after myocardial infarction

In 71 patients with a myocardial infarction (MI) (anterior in27, inferior in 44 patients) global (GEF) and regional (REF)left ventricular ejection fractions were determined by radionuclideventriculography and estimated from a 12 lead electrocardiogram(ECG), using Selvester's QRS score, during the early phase ofa MI (15 to 21 days following MI). Global ejection fractionsdetermined by radionuclide ventriculography and from ECG usingPalmeri's method were: for all M140.8 ± 12.6% vs 39.6± 11.4%; in the group of anterior M132.0 ± 10.0%vs 30.0 ± 9.7% and in the group of inferior MI 48.9±12.0%vs 45.1 ± 8.2%. A good correlation was found betweenglobal ejection fractions determined by radionuclide ventriculographyand ECG, as well as between radionuclide GEF and ECG score.A weaker correlation was found between radionuclide GEF andenzymes among all MIs and in the group of anterior MI, whilein the group of inferior MI this correlation was insignificant.The analysis of REF determined by radionuclide ventriculographyand ECG showed the greatest abnormalities in the infarct region,but in the group of anterior MI, dysfunction was present inthe whole left ventricle. The comparison of infarct-relatedREF derived from radionuclide ventriculography, with the QRSscore showed a significantly higher correlation than the comparisonwith enzymes. ECG estimation of REF from a modified Palmeri'sequation showed a better correlation with radionuclide REF thandid GEF derived from the standard Palmeri's equation: anteriorMI; r = 0.90 vs r = 0.82, inferior MI; r = 0.84 vs r = 0.69,respectively. Our results underline the value of relativelysimple ECG methods for the assessment of left ventricular globalfunction, and new possibilities for the estimation of regionalfunction in patients with myocardial infarction.