Exercise-induced ST-segment depression and systolic dysfunction in patients with nonobstructive hypertrophic cardiomyopathy

Background ST-segment depression is common in patients with hypertrophic cardiomyopathy (HCM). However, it is not clear whether exercise-induced ST-segment depression in patients with HCM and patent coronary arteries is associated with changes in left ventricular function. Methods Left ventricular f...

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Bibliographic Details
Published in:The American heart journal 2000-07, Vol.140 (1), p.52-60
Main Authors: Shimizu, Masami, Ino, Hidekazu, Okeie, Kazuyasu, Emoto, Yorito, Yamaguchi, Masato, Yasuda, Toshihiko, Fujino, Noboru, Fujii, Hiroyuki, Fujita, Shinichiro, Mabuchi, Tomohito, Taki, Junichi, Mabuchi, Hiroshi
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Analysis of Variance
Biological and medical sciences
Cardiomyopathy, Hypertrophic - complications
Cardiomyopathy, Hypertrophic - diagnosis
Echocardiography
Electrocardiography
Electrocardiography. Vectocardiography
Electrodiagnosis. Electric activity recording
Exercise Test
Female
Hemodynamics
Humans
Investigative techniques, diagnostic techniques (general aspects)
Logistic Models
Male
Medical sciences
Middle Aged
Monitoring, Physiologic - instrumentation
Probability
Recovery of Function
Systole
Ventricular Dysfunction, Left - diagnosis
Ventricular Dysfunction, Left - etiology
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Summary:Background ST-segment depression is common in patients with hypertrophic cardiomyopathy (HCM). However, it is not clear whether exercise-induced ST-segment depression in patients with HCM and patent coronary arteries is associated with changes in left ventricular function. Methods Left ventricular function was continuously evaluated in 53 patients with nonobstructive HCM during supine ergometer exercise with a radionuclide ventricular function monitor equipped with a cadmium telluride detector. On the basis of the ST-segment changes during exercise, the patients were divided into 2 groups: group N had no ST-segment depression, and group D had ≥0.1 mV ST-segment depression. Results Exercise duration, blood pressure, heart rate, and rate-pressure product during exercise did not differ between the 2 groups. End-diastolic volume at rest and at peak exercise did not differ between groups D and N. In contrast, the end-systolic volume in group N decreased during exercise, whereas in group D it increased. As a result, the left ventricular ejection fraction in group D decreased from 70% ± 7% to 59% ± 15% (P
ISSN:0002-8703
1097-6744
DOI:10.1067/mhj.2000.106642