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A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis
18:11

A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis

Published on: December 28, 2012

[Changes in ST segment on ECG of hypertensive patients]

G V Riabykina, L N Liutikova, M A Saidova

    Terapevticheskii Arkhiv
    |July 2, 2008
    PubMed

    Insights

    ST segment depression in hypertensive patients is often linked to left ventricular hypertrophy (LVH). Monitoring via Holter monitoring (HM) and bi-functional monitoring (BFM) reveals rhythm-dependent changes and potential myocardial strain.

    Area of Science:

    • Cardiology
    • Hypertension Research
    • Diagnostic Electrocardiography

    Background:

    • Hypertension frequently leads to left ventricular hypertrophy (LVH).
    • ST segment depression in hypertensive patients can be multifactorial, necessitating detailed investigation.
    • Understanding the correlation between ST changes and hemodynamic parameters is crucial for risk stratification.

    Purpose of the Study:

    • To evaluate ST depression in hypertensive patients with electrocardiographic signs of LVH.
    • To correlate ST segment changes with heart rate (HR) and blood pressure (BP) during Holter monitoring (HM) and bi-functional ECG and BP monitoring (BFM).
    • To compare ST depression with left ventricular contractility during stress-echocardiography in hypertensive patients with normal coronary arteries.

    Main Methods:

    • Analysis of 344 hypertensive patients without ischemic heart disease.
    • Correlation of ST depression with ECG signs of LVH in 192 patients.
    • Utilized Holter monitoring (HM) in 180 patients, bi-functional monitoring (BFM) in 122 patients, and stress-echocardiography in 30 patients with normal coronary arteries.

    Main Results:

    • ST depression was observed in 40 patients (12-lead ECG), with LVH signs in 65%.
    • HM revealed transient or persistent ST depression in 34 patients, often rhythm-dependent.
    • BFM identified ST depression related to HR/BP increases, including potential systolic myocardial strain syndrome in 2 cases. Stress-echocardiography showed ischemia criteria in 7 patients.

    Conclusions:

    • ST segment depression in hypertensive patients is frequently secondary to LVH-related repolarization disturbances.
    • Holter monitoring (HM) and bi-functional monitoring (BFM) can identify rhythm-dependent ST depressions and myocardial strain.
    • Microcirculatory disturbances may contribute to repolarization abnormalities in hypertensive patients, though causality is not always clear.
    Abstract

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