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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
Summary
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.