Despite reduced longitudinal shortening, LV wall thickening in patients with systemic hypertension remains unaltered due to relatively preserved circumferential shortening. Characterizing the disparities in LV principal strains reveals the presence of subclinical LV dysfunction and provides unique insights into functional adaptations that maintain global LV ejection fraction in patients with systemic hypertension.
Baseline characteristics associated with developing a clinical event or a markedly abnormal risk stratifying test were similar: rest anginal episode accompanied by ST-segment depression and occurring despite treatment with aspirin and heparin, a history of angina, older age, and family history of coronary disease. Patients with these characteristics are appropriate candidates for expeditious cardiac catheterization and consideration for revascularization, while patients without them may be suitable for medical management alone.
When a stress-induced perfusion defect exists on PET, revascularization improves sMBF in that region. When there is no such defect, sMBF shows no net change, whether or not intervention is performed in that area. PET stress may be useful for identifying areas of myocardium that could benefit from revascularization, and also areas in which intervention is unlikely to yield improvement in myocardial blood flow.
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