title: Correlation of ST-segment "hump sign" during exercise testing with impaired diastolic function of the left ventricle.
abstract: 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.
authors.affiliation: A' Department of Cardiology, University of Athens, Hippokration Hospital, Athens, Greece. michaelides@freemail.gr
authors.forename: Andreas P
authors.initials: AP
authors.lastname: Michaelides
authors.forename: Leonidas G
authors.initials: LG
authors.lastname: Raftopoulos
authors.forename: Constantina
authors.initials: C
authors.lastname: Aggeli
authors.forename: Charalambos
authors.initials: C
authors.lastname: Liakos
authors.forename: Charalambos
authors.initials: C
authors.lastname: Antoniades
authors.forename: Christos
authors.initials: C
authors.lastname: Fourlas
authors.forename: Elias
authors.initials: E
authors.lastname: Stamatopoulos
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Ioakeimides
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Soulis
authors.forename: Christodoulos
authors.initials: C
authors.lastname: Stefanadis
mesh_terms: 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*