@article{3141935,
    title = "ST Segment “Hump” during Exercise Testing and the Risk of Sudden
Cardiac Death in Patients with Hypertrophic Cardiomyopathy",
    author = "Michaelides, Andreas P. and Stamatopoulos, Ilias and Antoniades, and Charalambos and Anastasakis, Aris and Kotsiopoulou, Christina and and Theopistou, Artemisia and Misailidou, Maria and Fourlas, Christos and and Elliott, Perry M. and Stefanadis, Christodoulos",
    journal = "Annals of Noninvasive Electrocardiology",
    year = "2009",
    volume = "14",
    number = "2",
    pages = "158-164",
    publisher = "Wiley",
    issn = "1082-720X, 1542-474X",
    doi = "10.1111/j.1542-474X.2009.00291.x",
    keywords = "hypertrophic cardiomyopathy; sudden cardiac death; ST hump sign",
    abstract = "Background: The appearance of a discrete upward deflection of the ST
segment termed “the ST hump sign” (STHS) during exercise testing has
been associated with resting hypertension and exaggerated blood pressure
response to exercise.
Objective: We investigated the prevalence and clinical significance of
this sign in a population of patients with hypertrophic cardiomyopathy.
Methods: Eighty-one patients with hypertrophic cardiomyopathy (HCM) who
underwent cardiopulmonary exercise testing were followed in a
retrospective cohort study for a mean period of 5.3 years.
Results: The appearance of the STHS at the peak of exercise testing was
observed in 42 patients (52%), particularly in the inferior and the
lateral leads. Patients with the STHS had higher fractional shortening
and maximum left ventricular wall thickness and exhibited more
frequently outflow tract gradient > 30 mmHg at rest. Furthermore, the
presence of STHS was a strong independent predictor of the risk of
sudden cardiac death (SCD), as the latter occurred in eight of the
patients with this sign (8/42, 19%) and in none of the patients without
it (0/39, 0%) (P < 0.001).
Conclusion: The appearance of a “hump” at the ST segment during
exercise testing appears to be a risk factor for SCD in patients with
HCM. However, further studies are necessary to validate this finding in
larger populations and to elucidate the mechanism of the appearance of
the “hump.”
Ann Noninvasive Electrocardiol 2009;14(2):158-164."
}