ELECTROCARDIOGRAPHIC PATTERNS IN HYPERTEN SIVE PATIENTS WITHOUT ATHEROSCLEROTIC CORONARY-DISEASE - THE INFLUENCE OF THE LEFT-VENTRICULAR MASS

BACKGROUND: ECG ST-T segment abnormalities in hypertensive patients ar e traditionary associated with hypertrophy or ischaemia. Hypertensive patients with abnormalities in ST-T segment in DI, aVL and/or V-5-V-6 underwent an echocardiographic study in order to assess left ventricul ar structure. All of them, in adition to the electric changes, showed typical or non-typical thoracic disconfort showing a normal coronariog raphic study. METHODS: Hypertensive patients with ST-T segment changes were classified as follows: group A, 12 patients (8 women, 4 men, mea n age 63.6 +/- 7.2 years) with ECG image of left ventricular overload pattern; group B, 9 patients (3 men, 6 women, mean age 62.3 +/- 6.3 ye ar) with flat ST segment depression; and group C, 10 patients (3 men, 7 women, mean age 62.4 +/- 9.7 years) without changes on the ST-T segm ent with flat or negative T wave. Control group is made up 12 hyperten sive patients (7 women, 5 men, mean age 61.6 +/- 7.6 years) with norma l EGG. We assess by echocardiography interventricular septal thickness (IVST) and left ventricular posterior wall thickness (PWT) in mm, lef t ventricular end-diastolic diameter (DTD) in mm, left ventricular mas s (LVM) in grs, and the mass index (MI) in g/m(2). RESULTS: IVST, PWT, LVM and MI were significantly (p < 0.05) higher in the groups A, B an d C than in the control group. No statisticaly significant diferences were observed between the A, B and C groups. Stepwise discriminant ana lysis showed that the only parameter with independent value for discri minating between control, group and group ABC (the union of groups A, B and C) was IVST. CONCLUSIONS: In hypertensive patients without coron ariopathy, ST-T changes identify a group with greater left ventricular mass. The different electrocardiographic patterns considered were not associated with a significantly different left ventricular mass.