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Coronary flow velocity reserve in hypertensive patients with left ventricular systolic dysfunction

ValériaFontenelleAngelim Pereira1, CarvalhoFrimmClovis de, AnaClaraTude Rodrigues

  • 1Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil.

Clinical Cardiology
|March 14, 2002
PubMed

Insights

Coronary flow velocity reserve (CFVR) impairment is weakly linked to left ventricular (LV) dysfunction in hypertension. This study investigated CFVR in hypertensive patients with varying degrees of LV systolic dysfunction.

Area of Science:

  • Cardiology
  • Hypertension Research
  • Echocardiography

Background:

  • Hypertensive microvascular disease may limit left ventricular (LV) hypertrophy's ability to maintain systolic function.
  • The role of coronary reserve in hypertensive heart disease pathophysiology is unclear.

Purpose of the Study:

  • To investigate the progressive impairment of coronary flow velocity reserve (CFVR) in hypertension.
  • To correlate CFVR with the presence and severity of LV systolic dysfunction.

Main Methods:

  • Two groups of hypertensive patients (HP1, HP2) and normal subjects (NL) were studied using transesophageal echocardiography.
  • Doppler blood flow velocity in the left anterior descending coronary artery was measured at baseline and during adenosine infusion.
  • Coronary flow velocity reserve (CFVR) was calculated as the ratio of maximal to baseline peak diastolic flow velocities.

Main Results:

  • Left ventricular (LV) mass index and end-systolic wall stress increased progressively from NL to HP1 to HP2 groups.
  • Coronary flow velocity reserve (CFVR) was significantly reduced in hypertensive groups compared to controls (p < 0.05).
  • CFVR directly correlated with LV fractional shortening (FS%) and inversely with LV mass index and end-systolic stress.

Conclusions:

  • Coronary flow velocity reserve (CFVR) impairment shows a weak relationship with left ventricular (LV) dysfunction in hypertensive patients.
  • Findings suggest microvascular function may be compromised in hypertensive heart disease, even with preserved LV function.
Abstract

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