Document Detail


The antihypertensive treatment effect on left ventricular diastolic function is reflected in exercise electrocardiogram.
MedLine Citation:
PMID:  21920532     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND/PURPOSE: Exercise electrocardiographic hump sign is associated with uncontrolled arterial hypertension (AH), left ventricular (LV) diastolic dysfunction, and false-positive exercise testing (ET). The aim of this prospective study was to evaluate the antihypertensive treatment effect on hump and on pseudoischemic ST-segment depression and potential correlations to LV diastolic function and mass changes.
METHODS: The study comprised 59 non-coronary artery disease patients (45.9 years; 67.8% men) with never-treated arterial hypertension (143.2/95.1 mm Hg). Treadmill ET and echocardiography were performed at baseline and 6 months after pharmaceutical blood pressure normalization. Prevalence of hump and ST depression, transmitral (E/A) and tissue Doppler imaging (E'/A') early/late velocities ratios, E/E' ratio, and LV mass index (LVMI) were all defined.
RESULTS: Prevalence of hump was reduced from 69.5% to 23.7% and false-positive ETs from 35.6% to 18.6% (P < .05). Significant improvement (P < .05) was found in E'/A' ratio (0.68 vs 0.84), E/E' ratio (9.3 vs 7.9), and LVMI (109.2 vs 99.8 g/m(2)). Changes in hump were related to ST-depression changes (r = 0.632, P < .001) and to LV diastolic indices changes; patients with hump only at first ET (54.2%) improved E/A and E'/A' ratios, whereas patients with hump only at second ET (8.5%) worsened diastolic indices with similar changes in blood pressure and LVMI.
CONCLUSIONS: Antihypertensive treatment reduces the prevalence of hump and exercise ischemic-appearing ST depression probably through LV diastolic function improvement.
Authors:
Charalampos I Liakos; Andreas P Michaelides; Gregory P Vyssoulis; Evaggelos I Chatzistamatiou; Polychronis E Dilaveris; Maria I Markou; Christodoulos I Stefanadis
Publication Detail:
Type:  Journal Article; Randomized Controlled Trial     Date:  2011-09-13
Journal Detail:
Title:  Journal of electrocardiology     Volume:  45     ISSN:  1532-8430     ISO Abbreviation:  J Electrocardiol     Publication Date:    2012 Jan-Feb
Date Detail:
Created Date:  2012-01-06     Completed Date:  2012-04-27     Revised Date:  2013-02-22    
Medline Journal Info:
Nlm Unique ID:  0153605     Medline TA:  J Electrocardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  28-35     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 Elsevier Inc. All rights reserved.
Affiliation:
1st Cardiology Department, University of Athens Medical School, Hippokration Hospital, Athens, Greece.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Antihypertensive Agents / therapeutic use*
Diastole / drug effects*,  physiology
Echocardiography, Doppler
Electrocardiography*
Exercise / physiology*
Exercise Test
False Positive Reactions
Female
Humans
Hypertension / drug therapy*,  physiopathology*
Male
Middle Aged
Prospective Studies
Risk Factors
Ventricular Dysfunction, Left / drug therapy*,  physiopathology*,  ultrasonography
Chemical
Reg. No./Substance:
0/Antihypertensive Agents
Comments/Corrections
Erratum In:
J Electrocardiol. 2013 Jan-Feb;46(1):76

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


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