Endothelial and non-endothelial coronary blood flow reserve and left ventricular dysfunction in systemic hypertension
Clinics
; 64(4): 327-335, 2009. graf, tab
Article
in English
| LILACS
| ID: lil-511935
Responsible library:
BR1.1
ABSTRACT
OBJECTIVES:
We evaluated the impairment of endothelium-dependent and endothelium-independent coronary blood flow reserve after administration of intracoronary acetylcholine and adenosine, and its association with hypertensive cardiac disease.INTRODUCTION:
Coronary blood flow reserve reduction has been proposed as a mechanism for the progression of compensated left ventricular hypertrophy to ventricular dysfunction.METHODS:
Eighteen hypertensive patients with normal epicardial coronary arteries on angiography were divided into two groups according to left ventricular fractional shortening (FS). Group 1 (FS >0.25) n=8, FS=0.29 ± 0.03; Group 2 (FS <0.25) n=10, FS= 0.17 ± 0.03.RESULTS:
Baseline coronary blood flow was similar in both groups (Group 1 80.15 ± 26.41 mL/min, Group 2 100.09 ± 21.51 mL/min, p=NS). In response to adenosine, coronary blood flow increased to 265.1 ± 100.2 mL/min in Group 1 and to 300.8 ± 113.6 mL/min (p <0.05) in Group 2. Endothelium-independent coronary blood flow reserve was similar in both groups (Group 1 3.31 ± 0.68 and Group 2 2.97 ± 0.80, p=NS). In response to acetylcholine, coronary blood flow increased to 156.08 ± 36.79 mL/min in Group 1 and to 177.8 ± 83.6 mL/min in Group 2 (p <0.05). Endothelium-dependent coronary blood flow reserve was similar in the two groups (Group 1 2.08 ± 0.74 and group Group 2 1.76 ± 0.61, p=NS). Peak acetylcholine/peak adenosine coronary blood flow response (Group 1 0.65 ± 0.27 and Group 2 0.60 ± 0.17) and minimal coronary vascular resistance (Group 1 0.48 ± 0.21 mmHg/mL/min and Group 2 0.34 ± 0.12 mmHg/mL/min) were similar in both groups (p= NS). Casual diastolic blood pressure and end-systolic left ventricular stress were independently associated with FS.CONCLUSIONS:
In our hypertensive patients, endothelium-dependent and endothelium-independent coronary blood flow reserve vasodilator administrations had similar effects in patients with either normal or decreased ...
Full text:
Available
Collection:
International databases
Database:
LILACS
Main subject:
Vasodilator Agents
/
Endothelium, Vascular
/
Ventricular Dysfunction, Left
/
Coronary Circulation
/
Hypertension
Limits:
Female
/
Humans
/
Male
Language:
English
Journal:
Clinics
Journal subject:
Medicine
Year:
2009
Document type:
Article
Affiliation country:
Brazil
Institution/Affiliation country:
Universidade de São Paulo/BR