Author + information
- Received February 19, 1997
- Revision received October 3, 1997
- Accepted October 23, 1997
- Published online February 1, 1998.
- Alessia Gimelli, MDA,
- Jan Schneider-Eicke, MDA,
- Danilo Neglia, MDA,
- Gianmario Sambuceti, MDA,
- Assuero Giorgetti, MDA,
- Giovanni Bigalli, MDA,
- Guido Parodi, MDA,
- Roberto Pedrinelli, MDB and
- Oberdan Parodi, MDA,* ()
- ↵*Dr. Oberdan Parodi, CNR Institute of Clinical Physiology, 8, Via Savi 56100, Pisa, Italy.
Objectives. The aim of this study was to quantitatively measure regional and global myocardial blood flow and coronary reserve in hypertensive patients without coronary artery disease and to assess the correlation with left ventricular mass.
Background. The effect of left ventricular hypertrophy on regional vasodilating coronary capability in arterial hypertension is controversial, and no quantitative method has been applied to assess a possible correlation.
Methods. Positron emission tomography was performed in 50 untreated hypertensive patients and 13 normotensive subjects. Blood flow at baseline and after dipyridamole was globally and regionally measured by using nitrogen-13 ammonia; coronary reserve and resistance were calculated. Left ventricular mass was assessed by two-dimensional echocardiography.
Results. In hypertensive patients, flow at baseline was similar to that of normotensive subjects (p = 0.21), but values were reduced after pharmacologic vasodilation (p < 0.05). This impairment of maximal coronary flow was not correlated with left ventricular mass (p = 0.13). Among hypertensive patients, we identified a group with a homogeneous distribution of perfusion and a group with a heterogeneous flow pattern. Flow was globally reduced in the former group, but it was abnormal only at the site of perfusion defects in the latter. Patients with regional defects showed the highest likelihood of having an increased left ventricular mass.
Conclusions. In arterial hypertension, left ventricular mass is not correlated with global myocardial blood flow. Nevertheless, patients with ventricular hypertrophy are likely to show a heterogeneous flow pattern with regional defects and almost normal blood flow in nonaffected regions. In hypertensive patients with a homogeneous perfusion pattern during stress, myocardial blood flow frequently shows a diffuse reduction.
☆ This study was supported in part by the CNR-Targeted Project “Prevention and Control of Disease Factors,” Subproject “Control of Cardiovascular Disease,” from the National Research Council, Rome, Italy. Dr. Schneider-Eicke is the recipient of a training grant from the Human Capital and Mobility Project of the European Community, Brussels, Belgium.
This study was presented in part at the 45th Annual Scientific Session of the American College of Cardiology, Orlando, Florida, March 1996.
- Received February 19, 1997.
- Revision received October 3, 1997.
- Accepted October 23, 1997.
- The American College of Cardiology