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R-wave amplitude response to myocardial ischemia in hypertrophic cardiomyopathy

Tatsuya Kawasaki1, Yoshiki Akakabe, Michiyo Yamano

  • 1Department of Cardiology, Matsushita Memorial Hospital, Osaka, Japan. js-k@wf6.so-net.ne.jp

Journal of Electrocardiology
|September 22, 2007
PubMed

Insights

Exercise-induced R-wave amplitude changes did not effectively detect myocardial ischemia in patients with hypertrophic cardiomyopathy (HCM). This diagnostic approach showed no significant correlation with ischemia in the studied HCM cohort.

Area of Science:

  • Cardiology
  • Exercise Physiology
  • Diagnostic Imaging

Background:

  • Exercise-induced R-wave amplitude changes are a potential biomarker for myocardial ischemia.
  • Coronary heart disease (CHD) diagnosis can be enhanced by assessing R-wave amplitude during exercise.
  • Hypertrophic cardiomyopathy (HCM) presents unique challenges for cardiac diagnostics.

Purpose of the Study:

  • To evaluate the diagnostic utility of R-wave amplitude changes during exercise testing for detecting myocardial ischemia in patients with HCM.
  • To correlate exercise-induced R-wave amplitude variations with scintigraphically confirmed regional or diffuse subendocardial ischemia in HCM patients.

Main Methods:

  • Summation of R-wave amplitude across all 12 leads during exercise stress testing.
  • Correlation of R-wave amplitude response with scintigraphy findings to assess myocardial ischemia.
  • Comparison of R-wave amplitude changes in 49 HCM patients and 16 healthy controls.

Main Results:

  • A statistically significant decrease in summed R-wave amplitude during exercise was observed in both HCM patients (P < .01) and controls (P < .05).
  • No significant difference in the percentage change of summed R-wave amplitude was found among HCM subgroups with varying degrees or types of ischemia (P = .79).
  • Exercise-induced R-wave amplitude response did not differentiate between HCM patients with and without myocardial ischemia.

Conclusions:

  • The R-wave amplitude response to exercise is not a reliable indicator of myocardial ischemia in patients with hypertrophic cardiomyopathy.
  • Further research is needed to identify sensitive and specific diagnostic markers for ischemia in HCM.
Abstract

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