Evaluation of coronary flow reserve in hypertensive patients by dipyridamole transoesophageal doppler echocardiography

Hamouda, Mohamed S; Kassem, Hanan Kamel; Salama, Mai; Masry, M.M. El; Darwish, A.Z.; Sadek, Ekram; Shaaban, Naseem

doi:10.1016/s0895-7061(00)00830-x

Cited by 1 publication

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“…In observations carried out using trans-esophageal echocardiography, Kozakova et al [45] found that at maximal vasodilatation (using intravenous dipyridamole), diastolic flow velocity was similar in normotensive and hypertensive subjects, which implies that individuals with LVH have reduced maximal flow per unit mass and the coronary circulation does not increase in parallel with myocyte growth. In hypertensive patients without CAD but who complained of ischemicsounding chest pain, coronary flow reserve was lowest in those with LVH, but those without LVH also had reduced flow reserve when compared with normal controls [46].…”

Section: Coronary Flow Reservementioning

confidence: 82%

Hypertension, left ventricular hypertrophy, and sudden death

2002

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Left ventricular hypertrophy (LVH), a form of end-organ damage in hypertension, is associated with increased incidence of sudden cardiac death (SCD). This review explores the possible mechanisms behind this phenomenon. SCD in LVH could be thrombotic/ischemic or arrhythmic (eg, myocardial ischemia, even in the absence of significant coronary artery disease, may be one important factor). Abnormalities of flow-mediated dilatation, endothelial function, and a hypercoagulable state are well-observed abnormalities in association with hypertension and LVH, although their precise contributory role is as yet undefined in the pathogenesis of sudden death. Electrophysiologic abnormalities are also well documented in LVH, and such patients are more predisposed to arrhythmias. In the past decade, many studies have investigated the regression of LVH, and recent studies are addressing whether the latter translates into a prognostic benefit.

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Section: Coronary Flow Reservementioning

confidence: 82%