ST segment elevation and depression, and T-wave changes as electrophysiological signs of metabolic disorders with lipid and non-lipid risk factors for ischemic heart disease in the 25–44-year-old population

Aim. To study the associations of electrophysiological signs of metabolic disorders with lipid and non-lipid risk factors in the urban 25–44-year-old population.

Methods. A population survey (random sample) of Novosibirsk residents aged 25–44 years (656 men, 783 women) was conducted. The concentrations of total cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol, and triglycerides were determined. Systolic / diastolic blood pressure, body mass index, presence of arterial hypertension, and smoking status were evaluated. The following electrocardiographic markers of metabolic disturbances were analyzed: baseline non-ischemic ST elevation depression >0.5 mm, baseline ST elevation >0.5 mm, and T-wave changes (flattening, amplitude reduction, inversion).

Results. ST segment depression was detected in 4.2% of subjects (5.8% women, 2.4% men (p = 0.001)). ST segment elevation was detected in 28.5% of subjects (17.5% women, 41.6% men (p<0.001)). T-wave changes were detected in 18.9% of subjects (14.2% women, 24.5% men (p<0.001)). It was noted that men with elevated LDL-C levels and hypertension were more likely to have ST segment depression (1.4 and 1.9 times, respectively) than men without these abnormalities. In the general population, people with elevated LDL-C levels were 1.2 times more likely to have ST segment depression. Among men with ST segment elevation the concentration of LDL-C in the blood was 1.06 times higher than in men without ST segment elevation. People with a higher body mass index were 1.15 and 1.3 times more likely to have a T-wave change (in the general and female population, respectively). In the general population with T-wave changes, waist circumference and systolic blood pressure level were 1.02 and 1.02 times higher, respectively.

Conclusion. ST segment elevation and depression, and T-wave changes are associated with lipid and non-lipid risk factors for ischemic heart disease. The data obtained indicate a potentiating effect of metabolic disorders in the body on the development of risk factors for ischemic heart disease and metabolic cardiomyopathy.

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