Associations between ECG changes and echocardiographic findings in patients with acute non-ST elevation myocardial
Suvi Sirkku Tuohinen1, Jani Rankinen2, Tanja Skyttä3
1Heart and Lung Center, Helsinki University Central Hospital and Helsinki University; Faculty of Medicine and Life Sciences, University of Tampere, Finland; Heart Center, Tampere University Hospital, Finland.
Background:
ST segment depression (STD) and T wave inversion (TWI) are typical electrocardiographic (ECG) findings in non-ST elevation myocardial infarction (NSTEMI). In ST elevation myocardial infarction, ST changes represent transmural ischemia. The pathophysiological mechanisms of the ECG changes in NSTEMI are unclear.
Purpose:
We studied the associations between ECG and the echocardiographic findings in NSTEMI patients.
Methods:
Twenty patients with acute NSTEMI were recruited during their hospital stay. A comprehensive echocardiography study was performed. The findings were compared with blinded ECG analyses.
Results:
Nine (45%) patients had STD, and 16 (85%) patients had TWI. In multivariable analysis, STD was independently associated with a lower global early diastolic strain rate (β=-5.061, p=0.033). TWI was independently associated with lower circumferential strain (β=0.132, p=0.032).
Conclusions:
The typical ECG changes in NSTEMI patients were associated with subtle echocardiographic changes. STD was related to changes in diastolic function, and TWI was associated with systolic deterioration.
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