The association of left ventricular mass index with reciprocal ST depression in STEMI

Abstract

Introduction: In the pathogenesis of reciprocal ST depression in ST Elevation Myocardial Infarction (STEMI), severe and extensive coronary artery disease, presence of non-culprit obstructive lesions and larger infarct size have been asserted. Left ventricular hypertrophy (LVH) jeopardizes sub-endocardium to ischemia by means of increasing LV wall tension and leads larger necrotic areas in STEMI. We aim to investigate the association between left ventricular mass index and reciprocal ST depression in STEMI patients in the context of circumferential end systolic stress (cESS) as a measure of LV wall tension.

Materials and methods: A total of 269 patients who admitted to our hospital with STEMI between 2011–2014 were included. Patients were categorized into three groups according to LV mass index tertiles.

Results: The frequency of reciprocal ST depression was higher in the highest tertile (58.9%) than first (32.6%,p<0.001) and second tertile group (45.6%,p=0.002). cESS was higher in patients with reciprocal ST depression (113.8±51.7 vs. 98.0±44 p=0.008). Additionally, LV mass index was significantly correlated with cESS (β=0.391 P<0.001). In multivariate analysis, LV mass index was determined as an independent predictor of reciprocal ST changes (0R=1.014, 95% CI=1.005–1.023 p=0.002).In ROC analysis, a cut of value 101.2 has 61.2% sensitivity and 54.1% specificity for predicting reciprocal ST depression.