Correlation of ST-segment "hump sign" during exercise testing with impaired diastolic function of the left ventricle.
BACKGROUND
The appearance of a discrete upward deflection of the ST segment, termed the ST hump sign during exercise testing has been associated with resting hypertension and exaggerated blood pressure response to exercise.


OBJECTIVE
We investigated the correlation between the presence of hump sign during exercise testing with coexisting impaired diastolic function of the left ventricle (LV) at these patients.


METHODS
We formed a cohort of 237 nonconsecutive patients (140 males, 41 +/- 5 years old) having undergone a treadmill test, according to the Bruce protocol, which divided into 2 groups: group A, including 130 patients which presented ST-segment hump sign at any of the leads of the electrocardiograms recorded during exercise, and group B, including 107 patients that didn't. All patients subsequently underwent an echocardiographic estimation of the LV diastolic function, using conventional and Tissue Doppler Imaging techniques.


RESULTS
From 237 patients included in our study, 106 had echocardiographic signs of diastolic LV dysfunction. Among them, the appearance of ST hump sign at the peak of exercise testing was observed in 93 patients (88%), particularly in the inferior and lateral leads, while no ST hump sign was observed only in 13 patients (12%) with impaired diastolic LV function.


CONCLUSIONS
The appearance of ST segment hump sign during exercise testing is strongly correlated with diastolic LV dysfunction and can be used as an exercise electrocardiographic index of diastolic LV dysfunction, independently from the echocardiographic study.
Michaelides
Andreas P
AP
A' Department of Cardiology, University of Athens, Hippokration Hospital, Athens, Greece. michaelides@freemail.gr
Raftopoulos
Leonidas G
LG
Aggeli
Constantina
C
Liakos
Charalambos
C
Antoniades
Charalambos
C
Fourlas
Christos
C
Stamatopoulos
Elias
E
Ioakeimides
Nikolaos
N
Soulis
Dimitrios
D
Stefanadis
Christodoulos
C
D000328:Adult; D004562:Electrocardiography / Q000379:methods*; D005080:Exercise Test; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000175:diagnosis*; D008297:Male; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013223:Statistics as Topic; D018487:Ventricular Dysfunction, Left / Q000150:complications* / Q000175:diagnosis*