RESUMO
Background: Epidemiological evidence suggests that hypertensive patients with LVH are at risk of all manifestations of CAD. Recent interest focused on symptom-free hypertensive patients with LVH, since silent myocardial ischemia [SMI] perse, comprises an increased risk for cardiovascular morbidity and mortality
Aim of the Study: To assess the inicdnece of silent myocardial ischemia in hypertensive patients with LVH
Patients and Methods: Seventy five patients with systemic hypertension had been subdivided into two main groups: Group I [hypertensive with LVH 52/75] and group II [hypertensive without LVH 23/75]. All patients were subjected to: clinical assessment, non-invasive assessment [resting. ECG, ambulatory holter, exercise thallium] and invasive assessment [coronary angiography]
Results: Group I revealed two main subgroups: one subgroup with no evidence of myocardial ischemia by etither non-invasive or invasive tests [11/52] [group IA] and second group [IB] with positive non-invasive tests for myocardial ischemia [41/52]. However, 6/41 cases showed normal coronaries [IB1] and 35/41 showed CAD [IB2]. On the other hand, group II revealed negative both noninvasive and invasive tests for ischemia
Conclusion: Positive stress thallium test in hypertensive patients with LVH is an indication of myocardial ischemia even with normal coronary angiography. Patients of group IB1 explains ECG findings with strain