Relationship of ST-T Segment Abnormalities in Rest ECG with Left Ventricular Hypertrophy and Coronary Artery Disease in Patients with Hypertension

Abstract

Background Hypertensive patients often present with abnormal ST segment in rest ECG, which carries negative prognosis, although its determinants have not been fully explained.
Material and methods We investigated the group of 197 hypertensive patients with no previous myocardial infarction scheduled to coronary angiography because of chest pain (mean age 53 ± 9 ys, 33% women). Left ventricular hypertrophy was analysed with echocardiography.
Results Abnormal ST segment in rest ECG was present in 29% cases, it took form of left ventricular strain in 66% and in 34% it manifested as either isolated T wave abnormality or ST depression. Both types of abnormalities were not related to the presence of significant coronary artery disease (stenosis > 50%). Left ventricular strain was related to ventricular hypertrophy and isolated T wave abnormalities or ST depression were more prevalent in women.
Conclusions We conclude that ST segment abnormalities are common in hypertensives and that they are not related to the coronary stenosis, so their role in diagnosis of coronary artery disease in this group of patients is limited.