Regular paperCoronary flow reserve and myocardial diastolic dysfunction in arterial hypertension
Section snippets
Study population:
Between September 1998 and December 2000, 147 patients affected by newly diagnosed, never-treated arterial hypertension (World Health Organization/International Society of Hypertension grade 1 to 2) were screened at our outpatient clinic. Patients were defined as hypertensive if their diastolic BP was ≥90 mm Hg (mean of 3 different measurements on 3 different visits). Exclusion criteria were coronary artery disease (absence of angina pectoris and negative findings on the electrocardiogram at
Results
Characteristics of the population are listed in Table 1. High-dose dobutamine systolic BP was higher in patients with CFR <2. No patient complained of chest pain and no ST changes occurred using both stressors. Analyses of the Doppler echocardiographic data are listed in Table 2. Relative wall thickness and LV mass index were higher in patients with CFR <2. Doppler indexes were similar between the 2 groups.
The results of the dobutamine test and color tissue Doppler are listed in Table 3. Sm
Discussion
The present study used color tissue Doppler13, 14 and CFR determination10, 11, 12 to evaluate the possible association between LV myocardial diastolic function and CFR in arterial hypertension where changes in afterload and LV structure may influence both LV diastolic properties and coronary blood flow supply. Hypertensives were divided into 2 groups according to CFR level, with the cut-off point for normal CFR ≥2.11 The main findings of the study are: (1) hypertensives with abnormal CFR have a
Acknowledgements
The investigators are indebted to Liv Hatle, MD, for scientific comments, critical suggestions, and valuable review of the manuscript.
References (29)
- et al.
Abnormal left ventricular early diastolic filling during dobutamine stress Doppler echocardiography is a sensitive indicator of significant coronary artery disease
J Am Coll Cardiol
(1994) - et al.
Effect of coronary occlusion during percutaneous transluminal angioplasty on humans on left ventricular chamber stiffness and regional diastolic pressure-radius relation
J Am Coll Cardiol
(1986) - et al.
Abnormal coronary dynamics at rest and during tachycardia associated with impaired left ventricular relaxation in humansimplications for tachycardia-induced myocardial ischemia
J Am Coll Cardiol
(1994) - et al.
Noninvasive assessment of coronary flow reserve with transthoracic signal-enhanced Doppler echocardiography
J Am Soc Echocardiogr
(1999) - et al.
Use of segmental tissue Doppler velocity to quantitative exercise echocardiography
J Am Soc Echocardiogr
(1999) - et al.
Correlation of myocardial Doppler velocity response to exercise with independent evidence of myocardial ischemia by dual-isotope single-photon emission computed tomography
Am J Cardiol
(2000) - et al.
Recommendations for quantification of Doppler echocardiographya report from the Doppler quantification task force of the nomenclature and standard committee of the American Society of Echocardiography
J Am Soc Echocardiogr
(2002) - et al.
Stress echocardiographyrecommendations for perfomance and interpretation of stress echocardiography. Stress Echocardiography Task Force of the Nomenclature and Standards Committee of the American Society of Echocardiography
J Am Soc Echocardiogr
(1998) - et al.
Abnormal left ventricular fillingan early finding in mild to moderate systemic hypertension
Am J Cardiol
(1984) - et al.
Impact of heart rate and PR interval on Doppler indexes of diastolic filling in an elderly cohort
Am J Cardiol
(1993)
Attenuated coronary flow reserve and vascular remodeling in patients with hypertension and left ventricular hypertrophy
J Am Coll Cardiol
Left ventricular diastolic filling in hypertensionrelation to left ventricular mass and systolic function
J Am Coll Cardiol
Prevalence, clinical features and prognosis of diastolic heart failurean epidemiologic perspective
J Am Coll Cardiol
Upward shift of the lower range of coronary flow autoregulation in hypertensive patients with hypertrophy of the left ventricle
Circulation
Cited by (137)
Parathyroid hormone–PTH1R signaling in cardiovascular disease and homeostasis
2024, Trends in Endocrinology and MetabolismDeep neural networks for ECG-free cardiac phase and end-diastolic frame detection on coronary angiographies
2020, Computerized Medical Imaging and GraphicsCitation Excerpt :Similarly, identification of diastolic frames is required for the accurate determination of maximal flow acceleration in aortocoronary artery (AC) bypass grafts, successfully assessed as a potential predictor of graft failure (Handa et al., 2016). Finally, the determination of accurate diastolic flow velocities requires identification of the diastolic frames and is instrumental to the assessment of diastolic coronary flow reserve, which was shown to be independently associated with the myocardial diastolic function (Galderisi et al., 2002). Currently, the selection of the EDF and the identification of the cardiac phase are performed either manually or automatically based on simultaneously acquired ECG signals (Tröbs et al., 2016).
Hypertensive Heart Disease
2017, Encyclopedia of Cardiovascular Research and MedicineThe Hypertensive Myocardium: From Microscopic Lesions to Clinical Complications and Outcomes
2017, Medical Clinics of North America