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Lack of correlation between coronary flow reserve and vascular remodelling in hypertensive patients without left

Costas Tsioufis1, Georgios Latsios, Dimitrios Tsiachris

  • 1First Cardiology Clinic, University of Athens, Hippokration Hospital, Athens, Greece. ktsioufis@hippocratio.gr

Hellenic Journal of Cardiology : HJC = Hellenike Kardiologike Epitheorese
|November 27, 2012
PubMed

Insights

Coronary flow reserve (CFR) abnormalities in hypertensive patients are not linked to intima thickness (IT) or intima-media thickness (IMT) changes. This suggests microcirculatory dysfunction occurs independently of early structural changes in coronary arteries.

Area of Science:

  • Cardiology
  • Vascular Biology
  • Hypertension Research

Background:

  • Hypertension is a major risk factor for cardiovascular disease.
  • Coronary microvascular dysfunction can precede structural changes in coronary arteries.
  • Assessing early vascular changes in hypertension is crucial for risk stratification.

Purpose of the Study:

  • To investigate the relationship between coronary flow reserve (CFR) and coronary structural parameters (intima thickness [IT] and intima-media thickness [IMT]) in hypertensive patients.
  • To determine if impaired microcirculation in hypertension is associated with early atherosclerotic changes.
  • To evaluate functional versus structural vascular alterations in never-treated hypertensive individuals.

Main Methods:

  • Study included 13 never-treated hypertensive patients without left ventricular hypertrophy.
  • Coronary flow reserve (CFR) was measured using Doppler-guided pressure wire and adenosine infusion in the left anterior descending artery.
  • Coronary intima thickness (IT) and intima-media thickness (IMT) were assessed using optical coherence tomography (OCT).

Main Results:

  • Patients with low CFR (<2.5) had significantly higher aortic pulse pressure compared to those with normal CFR (>2.5).
  • No significant differences were observed in age, sex, left ventricular mass index, maximal IT, mean IT, maximal IMT, or mean IMT between low and normal CFR groups.
  • Coronary flow reserve (CFR) showed no correlation with IT or IMT in the overall hypertensive population.

Conclusions:

  • In hypertensive patients without left ventricular hypertrophy, adverse functional microcirculatory changes (assessed by CFR) are not accompanied by OCT-estimated alterations in coronary intima thickness (IT) and intima-media thickness (IMT).
  • This suggests that microvascular dysfunction in hypertension may occur independently of early structural changes in the coronary intima.
  • Further research is needed to elucidate the mechanisms of microcirculatory impairment in hypertension.
Abstract

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