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

M Shimizu·H Ino·K Okeie·Y Emoto·M Yamaguchi·T Yasuda·N Fujino·H Fujii·S Fujita·T Mabuchi·J Taki·H Mabuchi
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Abstract

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 <.0001), whereas ejection fraction in group N increased from 65% +/- 8% to 71% +/- 11% (P =.0002). There was a strong correlation between exercise-induced ST-segment depression and changes in ejection fraction from rest to peak exercise (P <.0001). CONCLUSIONS: These results suggest that the exercise-induced ST-segment depression seen in patients with nonobstructive HCM is associated with systolic dysfunction during exercise.

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AdolescentAdultAgedAnalysis of VarianceCardiomyopathy, HypertrophicEchocardiographyElectrocardiographyExercise TestFemaleHemodynamicsHumansLogistic ModelsMaleMiddle AgedMonitoring, PhysiologicProbabilityRecovery of FunctionSystoleVentricular Dysfunction, LeftClinical TrialComparative StudyJournal Article

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M Shimizu, H Ino, K Okeie, Y Emoto, M Yamaguchi, T Yasuda, N Fujino, H Fujii, S Fujita, T Mabuchi, J Taki, H Mabuchi. 2000. Exercise-induced ST-segment depression and systolic dysfunction in patients with nonobstructive hypertrophic cardiomyopathy.. https://doi.org/10.1067/mhj.2000.106642

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