title: The antihypertensive treatment effect on left ventricular diastolic function is reflected in exercise electrocardiogram.
abstract: OBJECTIVE
  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.affiliation: 1st Cardiology Department, University of Athens Medical School, Hippokration Hospital, Athens, Greece.
authors.forename: Charalampos I
authors.initials: CI
authors.lastname: Liakos
authors.forename: Andreas P
authors.initials: AP
authors.lastname: Michaelides
authors.forename: Gregory P
authors.initials: GP
authors.lastname: Vyssoulis
authors.forename: Evaggelos I
authors.initials: EI
authors.lastname: Chatzistamatiou
authors.forename: Polychronis E
authors.initials: PE
authors.lastname: Dilaveris
authors.forename: Maria I
authors.initials: MI
authors.lastname: Markou
authors.forename: Christodoulos I
authors.initials: CI
authors.lastname: Stefanadis
mesh_terms: D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D003971:Diastole / Q000187:drug effects* / Q000502:physiology; D015150:Echocardiography, Doppler; D004562:Electrocardiography; D015444:Exercise / Q000502:physiology*; D005080:Exercise Test; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000503:physiopathology*
chemical_list: D000959:Antihypertensive Agents