Background:Echocardiography(Echo) is the prime tool for assessing left ventricular ejection fraction (LVEF). Nevertheless, access to Echo may be limited in some facilities. Data regarding the correlation between ECG and LVEF is lacking. The aim of the study was to propose simplified criteria to asses LVEF based on ECG parameters in ACS patients.
Methods: We prospectively assigned 130 consecutive patients who were admitted to cardiac care unit at the Sheba medical center after sustaining myocardial infarction. ECG changes have been documented throughout the admission period in as well as LVEF in at least 2 Echo tests. An ECG scoring system(ESS) was built to predict LVEF [Start from EF=65%, then subtract points based on the finding below:Anterior Q waves(V2-V4)- 30 pts; Inferior Q waves(II,III,AVF)- 10 pts; Lateral Q waves(I,AVL,V5)- 15 pts; Septal Q waves (V1,V2)- 10 pts; Right Q waves(v1R,v2R,v3R)- 15 pts; Posterior Q waves- 15pts; ST↓- 10 pts; Low Voltage QRS (V2-V6)- 5 pts]. Patients were divided into 3 groups: A-EF≥45%; B-30%≥EF<45%; C-EF<30%. ESS was compared with the Echo findings.
Results: Out of 130 patients, the ESS predicated LVEF in 121(92%) patients. With 91% (104/114) prediction rate in group A; 92% (12/13)in group B and 100% (3/3)in group C.
Conclusions: The ESSdemonstrated high accuracy for prediction of LVEF following ACS. This can serve as a helpful tool to assess LVEF where access to Echo may be limited and/or when LVEF is lower than expected at the first days of ACS.
