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

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.