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Correlation between ECG and MCE findings in HCM patients and clinical implications
Baihetiya Tayier1, Chao Yuan1, Liyun Liu1
1Department of Echocardiography, Xinjiang Medical University Affiliated First Hospital, Urumqi, China; Xinjiang Key Laboratory of Ultrasound Medicine, Urumqi, China.
Insights
ST segment depression (STD) on electrocardiogram (ECG) exceeding 0.2 mV in hypertrophic cardiomyopathy (HCM) patients signals myocardial perfusion issues. This finding helps stratify HCM patients and identify those at higher risk.
Area of Science:
- Cardiology
- Diagnostic Imaging
- Biomedical Engineering
Background:
- Electrocardiogram (ECG) ST segment depression (STD) is a common indicator of myocardial ischemia.
- Myocardial contrast echocardiography (MCE) is a reliable method for assessing myocardial perfusion.
- The relationship between ECG, MCE, and clinical implications in hypertrophic cardiomyopathy (HCM) requires further elucidation.
Purpose of the Study:
- To investigate the correlation between ECG and MCE findings in HCM patients.
- To elucidate the clinical implications of these correlations.
- To assess the utility of STD in identifying perfusion abnormalities in HCM.
Main Methods:
- Thirty-two HCM patients and 28 healthy controls were enrolled.
- ST segment depression (STD) amplitude and MCE parameters (peak intensity, area under the curve, rising slope, time to peak) were recorded.
- HCM patients were subgrouped based on STD severity (ST1, ST2, ST3) for comparative analysis.
Main Results:
- All HCM patients exhibited STD (P < 0.001).
- HCM patients showed significantly reduced MCE parameters (PI, RS, AUC) compared to controls (P < 0.001).
- A significant difference in peak intensity (PI) was observed between STD severity groups (ST1 vs. ST3, P=0.01; ST2 vs. ST3, P=0.023).
Conclusions:
- ST segment depression (STD) exceeding 0.2 mV is a strong indicator of myocardial perfusion impairment in HCM patients.
- This ECG finding can reliably stratify HCM patients.
- STD serves as a valuable index for identifying high-risk HCM patients.
Background:
ST segment depression (STD) on electrocardiogram (ECG) is the most frequently used examination to detect myocardial ischemia and myocardial contrast echocardiography (MCE) is considered as a reliable technique to assess myocardial purfusion. However, association between two examinations and the underlying clinical implication in hypertrophic cardiomyopathy (HCM) patients is not fully illustrated.
Objective:
To investigate the correlation between ECG and MCE findings in HCM patients and elucidating the underlying clinical implications.
Methods:
Thirty-two patients diagnosed with HCM comprising the HCM cohort and 28 healthy individuals were enrolled as controls. The amplitude of ST segment depression (STD) was assessed, and the following MCE parameters: peak intensity (PI), area under the curve (AUC), rising slope (RS) and time to peak (TTP) were recorded and compared between the two groups, and correlation between MCE parameters and the extent of STD was calculated. Furthermore, HCM patients were categorized into three subgroups according to the severity of STD: ST1 group (0 < STD ≤ 0.1 mV); ST2 group (0.1 mV < STD ≤ 0.2 mV); ST3 group (0.2 mV < STD ≤ 0.3 mV), and data was compared among the four groups.
Results:
ECG showed that all patients in the HCM group present STD (t = 8.294, P < 0.001). MCE showed that the values of PI, RS, and AUC were significantly reduced in the HCM group as compared to the control group (P < 0.001). Results of correlation analysis show no linear correlation between the PI values and the extent of STD (r = -0.348, P = 0.051). Of note, a significant difference in PI values between ST1 and ST3 (P = 0.01), ST2 and ST3 (P = 0.023) was observed.
Conclusion:
Our findings reveal that STD greater than 0.2 mV strongly indicates myocardial perfusion impairment in HCM patients, and can serve as a reliable index for stratifying patients and identifying those at high risk.
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