Correlating both Aldrich and Hellemond score with cardiac magnetic resonance imaging endocardial surface area calculations in the estimation of the area at risk. Electrocardiography scores A and endocardial surface area calculations: Do they conelate?

Introduction: Having a bedside tool such as the ECG to assess the myocardial area at risk in a patient presenting with an ST-elevation myocardial infarction would be of great value to the clinician because this could give an insight in the efficiency of intervention therapy and the left ventricular rest function. Materials and Methods: From the MAST database (n = 106), we included 84 patients, all meeting the STEMI criteria, with a first anterior and/or inferior STEMI. From the admission ECG the Aldrich and Selvester scores were measured and the combined Hellemond score was calculated and correlated with the Cardiac Magnetic Resonance (CMR) estimated endocardial surface area (ESA) using the Spearman coefficient. Results: The correlation between the Aldrich score was r = 0.55 (p-value <0.0001) and Hellemond score r = 0.45 (p-value <0.0001) with ESA. After exclusion of lateral involvement the correlation increased to 0.62 (p-value <0.0001) for the Aldrich and to 0.49 (p-value <0.0001) for the Hellemond score. Conclusion: The additional ECG estimation of infarcted myocardium does not improve the ECG estimation of ischemic myocardium to CMR-based ESA estimation of the myocardial area at risk. The Aldrich score could be improved for STEMIs with lateral involvement.