Relationship between Nonspecific Electrocardiographic Abnormalities and Left Ventricular Performance in Coronary Atherosclerosis

Background: Nonspecific ST-T abnormalities (NSSTTA) have been associated with increased risk of cardiovascular mortality. The aim of this study was to investigate relationship between NSSTTA and left ventricular (LV) performance in coronary atherosclerosis. Methods: We reviewed 12-lead ECG in patients undergoing coronary angiography and echocardiography. NSSTTA (nonspecific ST-segment depression (≤−50 µV) and/or T-wave inversion (≤−100 µV) was interpreted by computerized analysis. The role of NSSTTA in atherosclerogenesis and LV performance was determined. Results: Inclusion criteria were met by 323 patients. LV mass was significantly greater in patients with NSSTA than those without (261.7 grams versus 217.9 grams, P=0.001). LV diastolic performance was significantly lower in patients with NSSTTA than those without (8.9 versus 7.0 represented by E/E′, P=0.014). However, there was no significant difference in LV ejection fraction between patients with and without NSSTTA (62.0% versus 63.2%, P=0.387). In addition, no significant association between NSSTTA and the severity of coronary stenosis was found (19.1 versus 17.9 expressed by Gensini score, P=0.762). Multivariate analysis identified that an independent determinants of NSSTTA was LV mass (P=0.008). Conclusions: NSSTTA was identified as a novel risk factor for initiating cardiovascular continuum.