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In Vivo Quantitative Assessment of Myocardial Structure, Function, Perfusion and Viability Using Cardiac Micro-computed Tomography
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[Exercise-induced ST-segment depression and myocardial ischemia in patients with hypertrophic cardiomyopathy:

Nobuyuki Miyai1, Tatsuya Kawasaki, Takuya Taniguchi

  • 1Department of Cardiology, Matsushita Memorial Hospital, Osaka. nobu-m0525@s4.dion.ne.jp

Journal of Cardiology
|October 29, 2005
PubMed

Insights

ST-segment depression during exercise is common in hypertrophic cardiomyopathy (HCM) patients. However, it appears to be an unreliable indicator of myocardial ischemia when assessed by exercise scintigraphy.

Area of Science:

  • Cardiology
  • Nuclear Cardiology
  • Exercise Physiology

Background:

  • Hypertrophic cardiomyopathy (HCM) can cause myocardial ischemia during exercise, even without coronary artery disease.
  • The diagnostic utility of ST-segment depression in identifying exercise-induced ischemia in HCM is not fully understood.

Purpose of the Study:

  • To investigate the relationship between myocardial ischemia and ST-segment depression during exercise testing in patients with HCM.
  • To assess the reliability of ST-segment depression as a marker for exercise-induced myocardial ischemia in HCM.

Main Methods:

  • Exercise 99mTc-tetrofosmin myocardial scintigraphy was used to assess regional hypoperfusion and left ventricular cavity dilation in 42 non-obstructive HCM patients.
  • Scintigraphic findings were correlated with ST-segment responses during exercise testing.

Main Results:

  • Regional hypoperfusion or transient left ventricular dilation was observed in 45% and 38% of HCM patients, respectively.
  • ST-segment depression (> or = 0.1 mV) occurred in 42% of patients with hypoperfusion and 38% with dilation, with no significant difference compared to those without (38%).
  • Exercise-induced ST-segment depression was not reliably associated with symptoms, exercise tolerance, or hypertrophy characteristics.

Conclusions:

  • ST-segment depression is a frequent finding during exercise testing in HCM patients.
  • ST-segment depression appears to be an unreliable marker for detecting myocardial ischemia in HCM when evaluated by exercise scintigraphy.
Abstract

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