Associations between ECG changes and echocardiographic findings in patients with acute non-ST elevation myocardial infarction

J Electrocardiol. 2018 Mar-Apr;51(2):188-194. doi: 10.1016/j.jelectrocard.2017.11.007. Epub 2017 Nov 21.

Abstract

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.

Keywords: ECG; Integrated backscatter; Non-ST elevation infarction; Speckle tracking echocardiography.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Diastole / physiology
  • Echocardiography*
  • Electrocardiography*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Non-ST Elevated Myocardial Infarction / diagnostic imaging*
  • Non-ST Elevated Myocardial Infarction / physiopathology*
  • Systole / physiology
  • Ventricular Dysfunction, Left / diagnostic imaging
  • Ventricular Dysfunction, Left / physiopathology