A012: Influence of concentric remodeling on coronary flow reserve in uncomplicated essential hypertension with normal left ventricular mass

• Published in: American journal of hypertension Vol. 13; no. S2; p. 44A
• Main Authors: Matsuzaki, K., Mukai, M., Takatsugi, K., Murakami, E.
• Format: Journal Article
• Language: English
• Published: Oxford Oxford University Press 01.04.2000
• Subjects: coronary flow reserve; Hypertension; remodeling
• ISSN: 0895-7061; 1941-7225; 1879-1905
• DOI: 10.1016/S0895-7061(00)00404-0

A reduced coronary flow reserve (CFR) is reported to be present already even in early stage of hypertension without left ventricular (LV) hypertrophy. The purpose of this study was to test the hypothesis whether LV geometric change (concentric remodeling) may be responsible for an impairment of CFR in uncomplicated hypertension with normal LV mass. From untreated patients with essential hypertension and normal LV mass (≤115 g/m2) on echocardiography, we selected sex- and age-matched two groups determined by relative wall thickness (RWT); patients with normal LV geometry (RWT < 0.45, n = 30), patients with concentric remodeling (RWT ≥ 0.45, n = 7). All patients underwent treadmill electrocardiography and/or coronary angiography to exclude coronary artery diseases. We assessed the washout rate (WR) obtained from intravenous dipyridamole thallium myocardial images (at 5 min and 240 min after dipyridamole and subsequent thallium injection) as a noninvasive marker of CFR. The following variables were evaluated between the two groups; WR, blood pressure (BP) level (office BP and 24-h ambulatory BP), LV fractional shortening determined by echocardiography, total cholesterol level and fasting glucose level. The WR was significantly decreased in patients with concentric remodeling than in those with normal LV geometry (33.1 ± 6.8 vs 40.2 ± 11.2%, P = 0.03). There were no significant differences in BP level, LV fractional shortening, total cholesterol level and fasting glucose level between these two groups. These findings indicate that a change of LV geometry from normal LV geometry to concentric remodeling may be associated strongly with the reduction in CFR in uncomplicated essential hypertension with normal LV mass.