| Coronary flow reserve and myocardial diastolic dysfunction in arterial hypertension. | |
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MedLine Citation:
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PMID: 12372574 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The aim of this study was to assess the relation between coronary blood flow and left ventricular (LV) myocardial diastolic dysfunction in arterial hypertension. The study population included 30 hypertensive patients who were free of coronary artery disease and pharmacologic therapies. They underwent standard Doppler echocardiography and color tissue Doppler of the middle posterior septum at baseline and with high-dose dobutamine, and second-harmonic Doppler flow analysis of the distal left anterior descending coronary artery at baseline and after vasodilation by dipyridamole (0.56 mg/kg IV in 4'). Coronary flow reserve (CFR) was estimated as the ratio of hyperemic and baseline diastolic flow velocities. According to CFR, hypertensives were divided into 2 groups: 15 patients with normal CFR (>/=2) and 15 patients with reduced CFR (<2). The 2 groups were comparable for sex, age, body mass index, baseline heart rate, and blood pressure. LV mass index was greater in hypertensives with reduced CFR (p <0.01). By color tissue Doppler, baseline and high-dose dobutamine septal systolic velocities did not differ between the 2 groups. The ratio between myocardial velocities in early diastole and at atrial contraction (E(m)/A(m) ratio) was lower in patients with reduced CFR, both at baseline (p <0.05) and with high-dose dobutamine (p <0.00001). After adjusting for age, body mass index, LV mass index, and both high-dose dobutamine diastolic blood rate and heart rate by a multiple linear regression analysis, E(m)/A(m) ratio at high-dose dobutamine was independently associated with CFR in the overall population (beta 0.62, p <0.0005) (cumulative R(2) 0.38, p <0.0005). In conclusion, this study provides evidence of an independent association between CFR and myocardial diastolic function. In hypertensive patients without coronary artery stenosis, CFR alteration may be a determinant of myocardial diastolic dysfunction or diastolic impairment that should be taken into account as possibly contributing to coronary flow reduction. |
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Authors:
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Maurizio Galderisi; Silvana Cicala; Pio Caso; Luigi De Simone; Arcangelo D'Errico; Antonio Petrocelli; Oreste de Divitiis |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The American journal of cardiology Volume: 90 ISSN: 0002-9149 ISO Abbreviation: Am. J. Cardiol. Publication Date: 2002 Oct |
Date Detail:
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Created Date: 2002-10-09 Completed Date: 2002-11-08 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 0207277 Medline TA: Am J Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 860-4 Citation Subset: AIM; IM |
Affiliation:
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Department of Clinical and Experimental Medicine, Federico II University of Naples, Naples, Italy. mgalderi@unina.it |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Blood Flow Velocity / physiology Cardiac Volume / physiology Coronary Circulation / physiology* Diastole / physiology* Dose-Response Relationship, Drug Echocardiography, Doppler* Echocardiography, Doppler, Color Echocardiography, Stress Female Humans Hypertension / physiopathology, ultrasonography* Hypertrophy, Left Ventricular / physiopathology, ultrasonography Male Middle Aged Myocardial Contraction / physiology* Reference Values Regional Blood Flow / physiology Ventricular Dysfunction, Left / physiopathology, ultrasonography* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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