Electrocardiographic Predictor of Final Infarct Size by Selvester QRS Score in Correlation to Rest Tc99M Sestamibi SPECT after Primary PCI

Objective: To assess the ability of Selvester QRS score to predict final size of myocardial infarction in correlation to rest Tc99 sestamibi SPECT in patients with ST-segment elevation myocardial infarction who underwent primary coronary intervention. Patients and Methods: The study was conducted on 30 patients with acute STEMI eligible for primary PCI. The initial and final size of myocardial infarction was estimated by Selvester QRS and resting Tc-99m sestamibi imaging then myocardial salvage was calculated. Results: The mean age was 55.27±10.74, 25 males (83.3%) and 5 females (16.7%). There was a significant correlation between Selvester QRS score and resting Tc-99m sestamibi imaging (r=0.774, p=0.001) for initial size, (r=0.659, p=0.001) for final size and (r=0.886, p=0.001) for myocardial salvage. Significant correlation was found in anterior MI patients (r=0.674, p=0.002) for initial size, (r=0.546, p=0.016) for final size and (r=0.936, p=0.001) for myocardial salvage. The correlation was significant in patients with post procedural TIMI 3 flow, it was (r=0.817, p=0.001) for initial size (r=0.678, p=0.001) for final size and r=0.939, p=0.001) for myocardial salvage. Also significant correlation in single vessel (r=0.955, p=0.001) for initial, (r=0.927, p=0.001) for final size and (r=0.989, p=0.001) for myocardial salvage. Time of reperfusion didn t affect the correlation as it was significant when reper-fusion was or 6hours. Conclusion: Selvester QRS score is simple, bedside, easy and cheap tool that correlate well with resting TC99 sestamibi SPECT for estimation the infarction size especially in patients with anterior MI, single vessel and with post procedure TIMI flow 3.