Open AccessCoronary flow velocity reserve in hypertensive patients with left ventricular systolic dysfunction
Author(s) -
Pereira Valéria Fontenelle Angelim,
De Carvalho Frimm Clovis,
Rodrigues Ana Clara Tude,
Tsutsui Jeane Mike,
Cúri Mariana,
Mady Charles,
Ramires José Antonio Franchini
Publication year - 2002
Publication title -
clinical cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.263
H-Index - 72
eISSN - 1932-8737
pISSN - 0160-9289
DOI - 10.1002/clc.4960250304
Subject(s) - medicine , cardiology , diastole , left ventricular hypertrophy , coronary flow reserve , doppler echocardiography , hypertensive heart disease , coronary artery disease , systole , muscle hypertrophy , pathophysiology , blood pressure , heart failure
Background : Hypertensive microvascular disease is speculated to be a limiting factor for the ability of left ventricular (LV) hypertrophy to maintain LV systolic function in systemic hypertension. The role of coronary reserve, which may be affected by microvascular disease, remains uncertain in the pathophysiology of hypertensive heart disease. Hypothesis : A progressive impairment of coronary flow velocity reserve (CFVR) according to the presence and severity of LV systolic dysfunction is anticipated to occur in hypertension. Methods : According to the absence or presence of LV dysfunction (LV fractional shortening ‐ FS% < 30), two groups of hypertensive patients were investigated: HP1 (n = 9, FS% = 36 ± 6) and HP2 (n = 13, FS% = 18 ± 6). Eight normal subjects (NL) served as controls (LVFS% = 35 ± 3). Doppler blood flow velocity was obtained from the left anterior descending coronary artery using transesophageal echocardiography before and during 6‐min continuous adenosine infusion (140 μg·kg‐1 ·min‐1 intravenous). The CFVR was calculated as the ratio of maximal to baseline peak diastolic flow velocities. Results : The comparison among NL, HP1, and HP2 groups showed statistically different (p < 0.05) mass index (101 ± 18, 172 ± 46, and 257 ± 54 g·m‐2), end‐systolic wall stress (76.9 ± 14.4, 78.4 ± 23.9, and 174.5 ± 43.0 103·dyn·cm‐2), and CFVR (3.5 ± 0.6, 3.2 ± 0.4, and 2.6 ± 0.8), respectively. The CFVR correlated significantly and directly with LVFS% (r = 0.40) and correlated inversely with both mass index (r = −0.54) and end‐systolic stress (r = −0.40). Conclusions: These results indicate that CFVR impairment is weakly related to LV dysfunction in hypertension.