Relation between left ventricular mass index [LVMI] and coronary artery disease in hypertensive patients with left ventricular hypertrophy [LVH]

ABSTRACT

It has been reported that coronary flow reserve decreased in nearly all patients when left ventricular mass index [LVMI] become 50% its normal values. Aim of Study Correlation between LVMI, exercise ECG and coronary angiography findings to determine timing of catheterization in ischemic hypertensive patients. Three hundred and eight seven patients had been divided into group I with no hypertension including 195 cases, and group II with hypertension and included 192. The latter group had been subdivided into hypertensive with no left ventricular hypertrophy [LVH] 83/192 group IIa, and hypertensive with LVH 109/192 group IIb. This group IIb has been subdivided again into group IIbl with LVMI <20% 23 cases, group IIb2 with LVMI 20-<50% 13 cases and group IIb3 with LVMI 50% and including 73 cases. All cases had been subjected to clinical assessment, non-invasive assessment [resting ECG, exercise ECG, and Echocardiogram] and invasive test [coronary angiography]. Group I revealed 135 cases [69.3%] while group II showed 126 [65.6%] with CAD. The highest prevalence of CAD was observed in group IIb3. Stress ECG could detect CAD in group I with sensitivity of 53.3% versus 69.8% in group II [p=0.05] and speeificity of 90% versus 78.8% respectively with p<0.05