Document Detail

Epicardial coronary artery size in hypertensive and physiologic left ventricular hypertrophy.
MedLine Citation:
PMID:  17324740     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: In the hypertensive heart, epicardial arteries are not enlarged, despite increased total coronary flow related to augmented cardiac workload, wall stress, and left ventricular (LV) mass. The aims of this study were to assess the impact of different hemodynamic factors and LV mass on baseline left main coronary artery (LMA) size in hypertensive LV hypertrophy (LVH) and physiologic LVH, used as a pressure-independent model of hypertrophy. METHODS: In 104 subjects without coronary disease (26 normotensive subjects without LVH, 15 athletes with physiologic LVH, and 63 untreated hypertensive subjects [28 without and 35 with LVH]), LMA size and coronary flow reserve (CFR) were measured by transesophageal echocardiography, and LV mass, volumes, stroke work, and wall stress were measured by transthoracic echocardiography. RESULTS: The LMA area in normotensive control subjects, athletes, and hypertensive subjects without and with LVH was 13.2 +/- 4.2, 17.5 +/- 2.9, 10.1 +/- 3.2 and 13.1 +/- 3.9 mm(2). In normotensive control subjects, LMA size increased with body surface area, rate-pressure product, stroke work, and LV mass or wall thickness (r = 0.39, 0.39, 0.47 and 0.67 or 0.62, P < .05-0.01). In athletes with physiologic LVH, LMA area increased with CFR (0.65, P < .01). In the whole hypertensive population, LMA lumen increased with LV mass (r = 0.40, P < .01), and decreased with office systolic blood pressure (r = -0.48, P < .01). CONCLUSIONS: In the hypertensive LVH, baseline LMA area is not increased and is inversely related to office systolic blood pressure. In the physiologic LVH, increase in baseline LMA size seems to reflect effect of high-flow stimuli.
Michaela Kozakova; Marco Paterni; Francesco Bartolomucci; Carmela Morizzo; Giuseppe Rossi; Fabio Galetta; Carlo Palombo
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American journal of hypertension     Volume:  20     ISSN:  0895-7061     ISO Abbreviation:  Am. J. Hypertens.     Publication Date:  2007 Mar 
Date Detail:
Created Date:  2007-02-27     Completed Date:  2007-04-20     Revised Date:  2009-02-24    
Medline Journal Info:
Nlm Unique ID:  8803676     Medline TA:  Am J Hypertens     Country:  United States    
Other Details:
Languages:  eng     Pagination:  279-84     Citation Subset:  IM    
Department of Internal Medicine, University of Pisa School of Medicine, Pisa, Italy.
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MeSH Terms
Blood Pressure
Cohort Studies
Coronary Circulation
Coronary Vessels / pathology*
Echocardiography, Transesophageal
Heart Ventricles / pathology
Hypertension / complications*,  pathology,  physiopathology
Hypertrophy, Left Ventricular / etiology*,  pathology*,  physiopathology
Middle Aged
Reproducibility of Results
Retrospective Studies
Comment In:
Am J Hypertens. 2007 Mar;20(3):285-6   [PMID:  17324741 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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