The ability of the electrocardiogram in left bundle branch block to detect myocardial scar determined by cardiovascular magnetic resonance

Björn Wieslander, Xiaojuan Xia, Robert Jablonowski, Jimmy Axelsson, Igor Klem, Robin Nijveldt, Charles Maynard, Erik B. Schelbert, Peder Sörensson, Andreas Sigfridsson, Uzma Chaudhry, Pyotr G. Platonov, Rasmus Borgquist, Henrik Engblom, Jean-Philippe Couderc, David G. Strauss, Brett D. Atwater, Martin Ugander

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Aims: We aimed to improve the electrocardiographic 2009 left bundle branch block (LBBB) Selvester QRS score (2009 LBSS) for scar assessment. Methods: We retrospectively identified 325 LBBB patients with available ECG and cardiovascular magnetic resonance imaging (CMR) with late gadolinium enhancement from four centers (142 [44%] with CMR scar). Forty-four semi-automatically measured ECG variables pre-selected based on the 2009 LBSS yielded one multivariable model for scar detection and another for scar quantification. Results: The 2009 LBSS achieved an area under the curve (AUC) of 0.60 (95% confidence interval 0.54–0.66) for scar detection, and R2 = 0.04, p < 0.001, for scar quantification. Multivariable modeling improved scar detection to AUC 0.72 (0.66–0.77) and scar quantification to R2 = 0.21, p < 0.001. Conclusions: The 2009 LBSS detects and quantifies myocardial scar with poor accuracy. Improved models with extensive comparison of ECG and CMR had modest performance, indicating limited room for improvement of the 2009 LBSS.
Original languageEnglish
Pages (from-to)779-786
JournalJournal of Electrocardiology
Volume51
Issue number5
DOIs
Publication statusPublished - 2018

Cite this

Wieslander, Björn ; Xia, Xiaojuan ; Jablonowski, Robert ; Axelsson, Jimmy ; Klem, Igor ; Nijveldt, Robin ; Maynard, Charles ; Schelbert, Erik B. ; Sörensson, Peder ; Sigfridsson, Andreas ; Chaudhry, Uzma ; Platonov, Pyotr G. ; Borgquist, Rasmus ; Engblom, Henrik ; Couderc, Jean-Philippe ; Strauss, David G. ; Atwater, Brett D. ; Ugander, Martin. / The ability of the electrocardiogram in left bundle branch block to detect myocardial scar determined by cardiovascular magnetic resonance. In: Journal of Electrocardiology. 2018 ; Vol. 51, No. 5. pp. 779-786.
@article{7f6e2850fab343a9957414e5ddeef1e0,
title = "The ability of the electrocardiogram in left bundle branch block to detect myocardial scar determined by cardiovascular magnetic resonance",
abstract = "Aims: We aimed to improve the electrocardiographic 2009 left bundle branch block (LBBB) Selvester QRS score (2009 LBSS) for scar assessment. Methods: We retrospectively identified 325 LBBB patients with available ECG and cardiovascular magnetic resonance imaging (CMR) with late gadolinium enhancement from four centers (142 [44{\%}] with CMR scar). Forty-four semi-automatically measured ECG variables pre-selected based on the 2009 LBSS yielded one multivariable model for scar detection and another for scar quantification. Results: The 2009 LBSS achieved an area under the curve (AUC) of 0.60 (95{\%} confidence interval 0.54–0.66) for scar detection, and R2 = 0.04, p < 0.001, for scar quantification. Multivariable modeling improved scar detection to AUC 0.72 (0.66–0.77) and scar quantification to R2 = 0.21, p < 0.001. Conclusions: The 2009 LBSS detects and quantifies myocardial scar with poor accuracy. Improved models with extensive comparison of ECG and CMR had modest performance, indicating limited room for improvement of the 2009 LBSS.",
author = "Bj{\"o}rn Wieslander and Xiaojuan Xia and Robert Jablonowski and Jimmy Axelsson and Igor Klem and Robin Nijveldt and Charles Maynard and Schelbert, {Erik B.} and Peder S{\"o}rensson and Andreas Sigfridsson and Uzma Chaudhry and Platonov, {Pyotr G.} and Rasmus Borgquist and Henrik Engblom and Jean-Philippe Couderc and Strauss, {David G.} and Atwater, {Brett D.} and Martin Ugander",
year = "2018",
doi = "10.1016/j.jelectrocard.2018.05.019",
language = "English",
volume = "51",
pages = "779--786",
journal = "Journal of Electrocardiology",
issn = "0022-0736",
publisher = "Churchill Livingstone",
number = "5",

}

Wieslander, B, Xia, X, Jablonowski, R, Axelsson, J, Klem, I, Nijveldt, R, Maynard, C, Schelbert, EB, Sörensson, P, Sigfridsson, A, Chaudhry, U, Platonov, PG, Borgquist, R, Engblom, H, Couderc, J-P, Strauss, DG, Atwater, BD & Ugander, M 2018, 'The ability of the electrocardiogram in left bundle branch block to detect myocardial scar determined by cardiovascular magnetic resonance' Journal of Electrocardiology, vol. 51, no. 5, pp. 779-786. https://doi.org/10.1016/j.jelectrocard.2018.05.019

The ability of the electrocardiogram in left bundle branch block to detect myocardial scar determined by cardiovascular magnetic resonance. / Wieslander, Björn; Xia, Xiaojuan; Jablonowski, Robert; Axelsson, Jimmy; Klem, Igor; Nijveldt, Robin; Maynard, Charles; Schelbert, Erik B.; Sörensson, Peder; Sigfridsson, Andreas; Chaudhry, Uzma; Platonov, Pyotr G.; Borgquist, Rasmus; Engblom, Henrik; Couderc, Jean-Philippe; Strauss, David G.; Atwater, Brett D.; Ugander, Martin.

In: Journal of Electrocardiology, Vol. 51, No. 5, 2018, p. 779-786.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - The ability of the electrocardiogram in left bundle branch block to detect myocardial scar determined by cardiovascular magnetic resonance

AU - Wieslander, Björn

AU - Xia, Xiaojuan

AU - Jablonowski, Robert

AU - Axelsson, Jimmy

AU - Klem, Igor

AU - Nijveldt, Robin

AU - Maynard, Charles

AU - Schelbert, Erik B.

AU - Sörensson, Peder

AU - Sigfridsson, Andreas

AU - Chaudhry, Uzma

AU - Platonov, Pyotr G.

AU - Borgquist, Rasmus

AU - Engblom, Henrik

AU - Couderc, Jean-Philippe

AU - Strauss, David G.

AU - Atwater, Brett D.

AU - Ugander, Martin

PY - 2018

Y1 - 2018

N2 - Aims: We aimed to improve the electrocardiographic 2009 left bundle branch block (LBBB) Selvester QRS score (2009 LBSS) for scar assessment. Methods: We retrospectively identified 325 LBBB patients with available ECG and cardiovascular magnetic resonance imaging (CMR) with late gadolinium enhancement from four centers (142 [44%] with CMR scar). Forty-four semi-automatically measured ECG variables pre-selected based on the 2009 LBSS yielded one multivariable model for scar detection and another for scar quantification. Results: The 2009 LBSS achieved an area under the curve (AUC) of 0.60 (95% confidence interval 0.54–0.66) for scar detection, and R2 = 0.04, p < 0.001, for scar quantification. Multivariable modeling improved scar detection to AUC 0.72 (0.66–0.77) and scar quantification to R2 = 0.21, p < 0.001. Conclusions: The 2009 LBSS detects and quantifies myocardial scar with poor accuracy. Improved models with extensive comparison of ECG and CMR had modest performance, indicating limited room for improvement of the 2009 LBSS.

AB - Aims: We aimed to improve the electrocardiographic 2009 left bundle branch block (LBBB) Selvester QRS score (2009 LBSS) for scar assessment. Methods: We retrospectively identified 325 LBBB patients with available ECG and cardiovascular magnetic resonance imaging (CMR) with late gadolinium enhancement from four centers (142 [44%] with CMR scar). Forty-four semi-automatically measured ECG variables pre-selected based on the 2009 LBSS yielded one multivariable model for scar detection and another for scar quantification. Results: The 2009 LBSS achieved an area under the curve (AUC) of 0.60 (95% confidence interval 0.54–0.66) for scar detection, and R2 = 0.04, p < 0.001, for scar quantification. Multivariable modeling improved scar detection to AUC 0.72 (0.66–0.77) and scar quantification to R2 = 0.21, p < 0.001. Conclusions: The 2009 LBSS detects and quantifies myocardial scar with poor accuracy. Improved models with extensive comparison of ECG and CMR had modest performance, indicating limited room for improvement of the 2009 LBSS.

UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85049538651&origin=inward

UR - https://www.ncbi.nlm.nih.gov/pubmed/30177312

U2 - 10.1016/j.jelectrocard.2018.05.019

DO - 10.1016/j.jelectrocard.2018.05.019

M3 - Article

VL - 51

SP - 779

EP - 786

JO - Journal of Electrocardiology

JF - Journal of Electrocardiology

SN - 0022-0736

IS - 5

ER -