Abstract
Background:ST-segment elevation (STE) in leads V1–2is often observed in patients with severe aortic stenosis (AS), but its significance remains unknown.Methods and Results:We retrospectively evaluated baseline ECGs and 5-year clinical outcomes in 211 consecutive patients with severe AS, defined as peak aortic jet velocity (Aortic Vmax) >4.0 m/s, or mean aortic pressure gradient >40 mmHg, or aortic valve area (AVA) <1.0 cm2. The primary outcome measure was a composite of death or surgical aortic valve replacement (AVR). Patients with STE in leads V1–2(≥0.15 mV) had greater Aortic Vmaxand smaller AVA than patients without. With a median follow-up of 4.9 years, the cumulative 5-year incidence of death or AVR was significantly higher in patients with STE in leads V1–2than in patients without (91.4% vs. 77.1%; P=0.003). After adjusting for confounders, STE in leads V1–2was independently associated with higher risk for death or AVR (hazard ratio, 1.53; 95% confidence interval, 1.06–2.22; P=0.02). In 64 asymptomatic patients without any indication for AVR at initial diagnosis of severe AS, the cumulative incidence of AVR was significantly higher in patients with STE in leads V1–2than in patients without (57.6% vs. 30.5%; P<0.001).Conclusions:STE in leads V1–2independently predicted poorer prognosis and more frequent need for AVR in patients with severe AS. (Circ J 2016; 80: 526–534)
