Document Detail


ST segment "hump" during exercise testing and the risk of sudden cardiac death in patients with hypertrophic cardiomyopathy.
MedLine Citation:
PMID:  19419401     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The appearance of a discrete upward deflection of the ST segment termed "the ST hump sign" (STHS) during exercise testing has been associated with resting hypertension and exaggerated blood pressure response to exercise. OBJECTIVE: We investigated the prevalence and clinical significance of this sign in a population of patients with hypertrophic cardiomyopathy. METHODS: Eighty-one patients with hypertrophic cardiomyopathy (HCM) who underwent cardiopulmonary exercise testing were followed in a retrospective cohort study for a mean period of 5.3 years. RESULTS: The appearance of the STHS at the peak of exercise testing was observed in 42 patients (52%), particularly in the inferior and the lateral leads. Patients with the STHS had higher fractional shortening and maximum left ventricular wall thickness and exhibited more frequently outflow tract gradient >30 mmHg at rest. Furthermore, the presence of STHS was a strong independent predictor of the risk of sudden cardiac death (SCD), as the latter occurred in eight of the patients with this sign (8/42, 19%) and in none of the patients without it (0/39, 0%) (P < 0.001). CONCLUSION: The appearance of a "hump" at the ST segment during exercise testing appears to be a risk factor for SCD in patients with HCM. However, further studies are necessary to validate this finding in larger populations and to elucidate the mechanism of the appearance of the "hump."
Authors:
Andreas P Michaelides; Ilias Stamatopoulos; Charalambos Antoniades; Aris Anastasakis; Christina Kotsiopoulou; Artemisia Theopistou; Maria Misailidou; Christos Fourlas; Perry M Elliott; Christodoulos Stefanadis
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc     Volume:  14     ISSN:  1542-474X     ISO Abbreviation:  Ann Noninvasive Electrocardiol     Publication Date:  2009 Apr 
Date Detail:
Created Date:  2009-05-07     Completed Date:  2009-08-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9607443     Medline TA:  Ann Noninvasive Electrocardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  158-64     Citation Subset:  IM    
Affiliation:
First Department of Cardiology, Athens Medical School, Hippokratio Hospital, Athens, Greece. michaelides@freemail.gr
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MeSH Terms
Descriptor/Qualifier:
Adult
Cardiomyopathy, Hypertrophic / epidemiology*,  physiopathology*
Cohort Studies
Death, Sudden, Cardiac / epidemiology*
Electrocardiography / methods*
Exercise Test / methods*,  statistics & numerical data*
Female
Follow-Up Studies
Greece / epidemiology
Humans
Male
Predictive Value of Tests
Prevalence
Retrospective Studies
Risk Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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