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[Echocardiographic evaluation of coronary flow reserve in patients with essential hypertension]

G Arcidiacono1, L Privitelli, A Laurenti

  • 1Divisione Clinicizzata di Medicina Interna e Specialità Internistiche, Università degli Studi di Catania, Azienda Ospedaliera Garibaldi, Catania, Italy.

Minerva Cardioangiologica
|February 7, 2002
PubMed

Insights

Essential arterial hypertension (EAH) causes early coronary alterations, reducing coronary blood flow reserve even before left ventricular hypertrophy (LVH). This increases coronary event risk in hypertensive patients.

Area of Science:

  • Cardiology
  • Vascular Biology
  • Hypertension Research

Background:

  • Essential arterial hypertension (EAH) can lead to left ventricular hypertrophy (LVH).
  • LVH causes structural and functional changes in coronary vessels, potentially impairing coronary blood flow reserve.
  • Early detection of coronary alterations in hypertension is crucial for risk stratification.

Purpose of the Study:

  • To evaluate coronary blood flow and vasodilatation capacity in hypertensive patients with and without LVH.
  • To assess coronary blood flow reserve under basal conditions and during dipyridamole infusion.
  • To compare these parameters between hypertensive subjects and normotensive controls.

Main Methods:

  • Eighty patients (50 hypertensive with/without LVH, 30 normotensive) were selected using ECG, echo color Doppler, and transesophageal echocardiography.
  • Transesophageal echocardiography was performed before and during intravenous dipyridamole infusion.
  • The study observed patients for 18 months with no dropouts.

Main Results:

  • Coronary resistances decreased during dipyridamole infusion in hypertensive patients but remained higher than in controls.
  • Hypertensive subjects showed reduced coronary vasodilatation capability, possibly due to increased basal tone or reduced vessel compliance.
  • Coronary blood flow reserve was significantly reduced in all hypertensive patients, including those without LVH.

Conclusions:

  • Essential arterial hypertension is a primary cause of early coronary anatomical and functional alterations.
  • These alterations increase the risk of coronary events in hypertensive individuals, even before the development of LVH.
  • Hypertension itself, independent of LVH, impacts coronary physiology and reserve.
Abstract

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