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Coronary haemodynamics in left ventricular hypertrophy
1Department of Medical Cardiology, Royal Infirmary, Glasgow.
Heart (British Cardiac Society)
|April 1, 1996
Summary
Patients with left ventricular hypertrophy have reduced coronary blood flow, indicating an inadequate blood supply. This study found no upward shift in the autoregulation range during hypotension, despite observed electrocardiographic changes.
Area of Science:
- Cardiovascular Physiology
- Clinical Cardiology
- Hemodynamics
Background:
- Left ventricular hypertrophy (LVH) increases cardiovascular risks.
- LVH patients show ECG changes and dysfunction during hypotension.
- Previous research suggested an upward shift in autoregulation limits.
Purpose of the Study:
- To quantify coronary blood flow (velocity) and reserve during acute hypotension in LVH patients.
- To investigate the impact of hypotension on coronary hemodynamics in LVH.
Main Methods:
- Studied patients with LVH (hypertensive or atypical chest pain) and normal epicardial vessels.
- Measured left coronary blood flow velocity at rest and during hyperemia (adenosine) under induced hypotension (sodium nitroprusside).
- Assessed left ventricular mass via echocardiography and coronary blood flow using Doppler catheter and quantitative angiography.
Main Results:
- Coronary blood flow velocity was stable with physiological blood pressure but sensitive to pressure changes during maximal hyperemia.
- Absolute coronary blood flow, normalized for LV mass, was lower in hypertensive LVH patients at rest and during hyperemia.
- No upward shift in the lower limit of coronary autoregulation was detected.
Conclusions:
- Findings suggest an insufficient blood supply to the hypertrophied heart.
- The study did not support an upward shift in the autoregulatory range of coronary blood flow in LVH patients during hypotension.