[Phenomenon of myocardial ischemia in patients with essential arterial hypertension with unaffected coronary arteries]. / Fenomen ishemii miokarda u bol'nykh éssentsial'noi arterial'noi gipertoniei s neizmenennymi koronarnymi arteriiami.

Cause-effect relationships (CER) between development of ischemia and ischemic damage to hypertrophic myocardium were studied in 128 hypertensive patients (23 females, 105 males aged 35 to 58 years, mean age 52.3 +/- 1.2 years). CER were assessed basing on clinical condition of the patient, results of functional stress tests (transesophageal atrial pacing-TAP), Holter ECG and arterial pressure monitoring, changes in serum myoglobin levels. The analysis of correlations between development of left-ventricular myocardial hypertrophy, frequency and duration of painless ischemic episodes, severity of ischemic damage has established that duration of painless ST depression directly and significantly correlated with left ventricular myocardial mass (r = 0.88, p < 0.01). It was found that hypertensive patients with elevated serum myoglobin and its normal values differed significantly both by after-TAP number of episodes of painless ST depression (12.5 +/- 2.69 vs 5.66 +/- 0.86; p < 0.002) and by their duration (4.1 +/- 1.02 min vs 2.45 +/- 0.41 min, respectively; p < 0.001). Clinical implications of elevated concentration of serum myoglobin in hypertensive patients with unaffected coronary arteries were defined.