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Relation between left ventricular midwall function and coronary vasodilator capacity in arterial hypertension

Michaela Kozàkovà1, Ele Ferrannini, Carlo Palombo

  • 1Department of Internal Medicine and CNR Institute of Clinical Physiology, University of Pisa School of Medicine, Pisa, Italy.

Hypertension (Dallas, Tex. : 1979)
|September 4, 2003
PubMed

Insights

Depressed left ventricular midwall shortening in hypertension is linked to worse coronary function and more exercise-induced myocardial ischemia. This suggests impaired myocardial performance may stem from reduced coronary vasodilator capacity.

Area of Science:

  • Cardiology
  • Cardiovascular Physiology

Background:

  • Systemic hypertension is associated with adverse cardiovascular outcomes.
  • Depressed left ventricular midwall shortening and increased relative wall thickness are linked to poor prognosis and reduced coronary reserve in hypertensive individuals.

Purpose of the Study:

  • To investigate the association between depressed midwall shortening and impaired coronary function.
  • To determine if depressed midwall shortening correlates with exercise-induced myocardial ischemia in untreated hypertensive patients.

Main Methods:

  • Sixty untreated hypertensive patients and 20 healthy volunteers underwent exercise ECG, echocardiography, and coronary vasodilator capacity assessment.
  • Evaluated left ventricular mass, geometry, midwall shortening, and exercise-induced myocardial ischemia.

Main Results:

  • Hypertensive patients with depressed midwall shortening exhibited higher minimum coronary resistance and a greater prevalence of exercise-induced myocardial ischemia compared to those with normal midwall shortening.
  • Midwall shortening was inversely related to minimum coronary resistance within the hypertensive group.
  • Patients with exercise-induced myocardial ischemia showed higher minimum coronary resistance and lower midwall shortening.

Conclusions:

  • Depressed midwall shortening in hypertensive patients indicates more severe coronary function impairment and higher rates of myocardial ischemia.
  • Reduced myocardial performance may be partly due to chronic ischemia from impaired coronary vasodilator capacity.

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