Document Detail

Systolic ventricular dysfunction and heart failure due to coronary microangiopathy in hypertensive heart disease.
MedLine Citation:
PMID:  7495218     Owner:  NLM     Status:  MEDLINE    
Left ventricular hypertrophy in arterial hypertension is characterized by myocyte hypertrophy, myocardial fibrosis, and structural changes of the intramural coronary arteries. Hypertensives with or without left ventricular hypertrophy have a reduced coronary vasodilator reserve due to alterations of the coronary microcirculation. The impairment in coronary vasodilator reserve is likely to initiate a process of malperfusion and malnutrition concomitant with increased metabolic demands. Further, malperfusion is supported by an increase in diastolic filling pressure, which will enhance the extravascular component of coronary resistance. The sum of interactions of these structural alterations of myocardium, interstitium, and coronary vasculature are likely to initiate and maintain a process of myocardial malperfusion and malnutrition, which can provoke functional depression of the myocardial performance, a loss of contractile proteins, an increase in interstitial fibrosis, and, not least, an overall decrease in contractile function in long-standing cardiac hypertrophy. Finally, the reversal of these processes by adequate antihypertensive treatment may contribute to renormalization of cardiac function and to prevention of late cardiac failure in hypertensive heart disease.
M Vogt; B E Strauer
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  The American journal of cardiology     Volume:  76     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  1995 Nov 
Date Detail:
Created Date:  1996-01-11     Completed Date:  1996-01-11     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  48D-53D     Citation Subset:  AIM; IM    
Medical Clinic, Heinrich-Hèine-University of Düsseldorf, Germany.
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MeSH Terms
Antihypertensive Agents / therapeutic use
Coronary Circulation / drug effects
Coronary Disease / drug therapy,  etiology*
Endomyocardial Fibrosis / etiology,  prevention & control
Heart Failure / etiology*,  prevention & control
Hypertension / complications*,  drug therapy
Microcirculation / drug effects
Myocardial Contraction
Myocardial Ischemia / etiology,  prevention & control
Ventricular Dysfunction, Left / etiology*,  prevention & control
Ventricular Pressure / drug effects
Reg. No./Substance:
0/Antihypertensive Agents

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

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