QRS SCORE AS AN INDICATOR OF MYOCARDIAL VIABILITY AFTER THROMBOLYTIC THERAPY

Electrocardiographic estimation of myocardial injury has, in some stud ies, correlated poorly with the extent of nuclear perfusion defects at rest and with changes in the left ventricular ejection fraction after acute reperfusion therapy. The authors investigated 16 patients with fatty acid scintigraphy and with the Selvester-Wagner QRS score 2 week s and 3 months after an anterior myocardial infarction. Segmental upta ke on tomographic scans was semiquantitatively classified as low, mode rate, or normal. The analysis included a total of 707 segments. QRS sc ores and the number of segments with low fatty acid uptake did not sig nificantly change during the follow-up period, although the number of segments with moderate fatty acid uptake decreased from 15.9 +/- 5.1 t o 12.4 +/- 5.7 (P < .05). The QRS score correlated significantly (rho = .56-.64) with low fatty acid uptake, but not with moderate fatty aci d uptake. It is concluded that the QRS score is related to the degree of permanent myocardial injury, even after thrombolysis.