Document Detail

Exercise-Induced ST Elevation in Patients With Non-Ischemic Dilated Cardiomyopathy and Narrow QRS Complexes.
MedLine Citation:
PMID:  23291994     Owner:  NLM     Status:  Publisher    
Background: The clinical significance and prevalence of exercise-induced ST elevation (ESTE) in non-ischemic dilated cardiomyopathy (NIDCM) patients are unknown. Methods and Results: We retrospectively examined 12-lead ECGs during cardiopulmonary exercise testing in 360 consecutive NIDCM patients (left ventricular ejection fraction (LVEF) <45%) with narrow QRS. ESTE was defined as ≥1.0mm ST (J-point) elevation compared with baseline. During long-term follow-up for major cardiac events (death, transplantation, or LV assist device implantation), ESTE was recognized in 50 patients (14%). They had much lower LVEF than patients without ESTE (20±7% vs. 27±7%, respectively, P<0.001), whereas the differences in peak VO(2) (P=0.01) and VE/VCO(2) slope (P=0.04) were relatively small. Major cardiac events occurred more frequently in patients with ESTE than in those without ESTE (39% vs. 12% at 48 months). Increased event rates were associated with low peak VO(2) (<14ml·min(-1)·kg(-1)) in patients without ESTE (39% vs. 23%, P<0.05), but not in those with ESTE (50% vs. 62%, NS). Cox multivariate analysis revealed ESTE as the strongest independent prognosticator among exercise parameters (hazard ratio: 2.41 [95% confidence interval 1.03-5.63], P<0.05). Conclusions: A substantial number of NIDCM patients exhibit ESTE, which indicates a poor prognosis. Low peak VO(2) and ESTE may reflect different aspects of the pathophysiological processes that deteriorate heart failure.
Hiroyuki Takahama; Hiroshi Takaki; Yusuke Sata; Kazushi Sakane; Yasushi Ino; Teruo Noguchi; Yoichi Goto; Masaru Sugimachi
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-12-29
Journal Detail:
Title:  Circulation journal : official journal of the Japanese Circulation Society     Volume:  -     ISSN:  1347-4820     ISO Abbreviation:  Circ. J.     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2013-1-7     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101137683     Medline TA:  Circ J     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center.
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