Document Detail

Augmented ST-segment elevation during recovery from exercise predicts cardiac events in patients with Brugada syndrome.
MedLine Citation:
PMID:  21029874     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: The goal of this study was to evaluate the prevalence and the clinical significance of ST-segment elevation during recovery from exercise testing.
BACKGROUND: During recovery from exercise testing, ST-segment elevation is reported in some patients with Brugada syndrome (BrS).
METHODS: Treadmill exercise testing was conducted for 93 patients (91 men), 46 ± 14 years of age, with BrS (22 documented ventricular fibrillation, 35 syncope alone, and 36 asymptomatic); and for 102 healthy control subjects (97 men), 46 ± 17 years of age. Patients were routinely followed up. The clinical end point was defined as the occurrence of sudden cardiac death, ventricular fibrillation, or sustained ventricular tachyarrhythmia.
RESULTS: Augmentation of ST-segment elevation ≥0.05 mV in V(1) to V(3) leads compared with baseline was observed at early recovery (1 to 4 min at recovery) in 34 BrS patients (37% [group 1]), but was not observed in the remaining 59 BrS patients (63% [group 2]) or in the 102 control subjects. During 76 ± 38 months of follow-up, ventricular fibrillation occurred more frequently in group 1 (15 of 34, 44%) than in group 2 (10 of 59, 17%; p = 0.004). Multivariate Cox regression analysis showed that in addition to previous episodes of ventricular fibrillation (p = 0.005), augmentation of ST-segment elevation at early recovery was a significant and independent predictor for cardiac events (p = 0.007), especially among patients with history of syncope alone (6 of 12 [50%] in group 1 vs. 3 of 23 [13%] in group 2) and among asymptomatic patients (3 of 15 [20%] in group 1 vs. 0 of 21 [0%] in group 2).
CONCLUSIONS: Augmentation of ST-segment elevation during recovery from exercise testing was specific in patients with BrS, and can be a predictor of poor prognosis, especially for patients with syncope alone and for asymptomatic patients.
Hisaki Makimoto; Eiichiro Nakagawa; Hiroshi Takaki; Yuko Yamada; Hideo Okamura; Takashi Noda; Kazuhiro Satomi; Kazuhiro Suyama; Naohiko Aihara; Takashi Kurita; Shiro Kamakura; Wataru Shimizu
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  56     ISSN:  1558-3597     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-10-29     Completed Date:  2010-11-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1576-84     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2010 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan.
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MeSH Terms
Brugada Syndrome / complications,  mortality,  physiopathology*
Death, Sudden, Cardiac* / etiology
Exercise Test / methods*
Follow-Up Studies
Middle Aged
Predictive Value of Tests
Tachycardia, Ventricular / etiology,  mortality,  physiopathology*
Ventricular Fibrillation / etiology,  mortality,  physiopathology*
Comment In:
J Am Coll Cardiol. 2010 Nov 2;56(19):1585-8   [PMID:  21029875 ]

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