Attenuated coronary flow reserve and vascular remodeling in patients with hypertension and left ventricular hypertrophy
Attenuated coronary flow reserve and vascular remodeling in patients with hypertension and left ventricular hypertrophy
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DOI：
10.1016/s0735-1097(00)00594-5
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发表时间：
2000-05-01
影响因子：
24
通讯作者：
Lerman, A
中科院分区：
文献类型：
--
作者：
Hamasaki, S;Al Suwaidi, J;Lerman, A
目的探讨高血压和左心室肥厚与冠状动脉血管重构和内皮功能的关系。背景：高血压和左心室肥厚患者的血管重构与非内皮冠脉血流储备之间的关系尚不清楚。方法对111例冠状动脉造影正常或轻度病变的患者进行冠状动脉左前降支血管内超声检查。将患者分为3组：高血压伴左室肥厚组13例，高血压不伴左室肥厚组30例，血压正常组68例。测定血管管腔面积和动脉粥样硬化斑块面积。结果冠脉内腺苷和乙酰胆碱测定血管反应性。结果左心室肥厚组血管面积显著大于无左室肥厚组(P<0.01)，而两组血管面积无显著差异(12.8±0.8 mm(2)、10.7±0.4 mm(2)和11.5±0.3 mm(2))。第1组(伴LVH)患者基线冠状动脉血流量显著高于第2组和第3组患者(分别为81.1+/-9.9ml/min、56.5+/-6.2ml/min和48.1+/-3.2ml/min，P均<0.05)。与第2组和第3组相比，LVH患者对乙酰胆碱和腺苷的反应性均显著降低。结论高血压合并LVH与冠状动脉血管重塑及内皮和非内皮冠状动脉血流储备减弱有关。(C)2000年由美国心脏病学会颁发。
OBJECTIVES The purpose of this study was to evaluate the association between hypertension and left ventricular hypertrophy (LVH) with both coronary vascular remodeling and endothelial function.BACKGROUND The association between endothelial and nonendothelial coronary flow reserve with vascular remodeling in patients with hypertension and LVI-I is still unclear.METHODS One hundred and eleven patients with normal or mildly diseased coronary arteries at angiography underwent intravascular ultrasound examination of the left anterior descending coronary artery. Patients were divided into three groups: group I: n = 13, hypertensive patients with LVH; group 2: n 30, hypertensive patients without LVH; group 3: n 68, normotensive patients. Vessel and lumen area and atherosclerotic plaque area were evaluated. Vascular reactivity was examined using intracoronary adenosine and acetylcholine.RESULTS Vessel area in group 1 (with LVH) was significantly (p < 0.01) greater than that in group 2 (without LVH), whereas, vessel area in both groups 1 and 3 was similar (12.8 +/- 0.8 mm(2), 10.7 +/- 0.4 mm(2) and 11.5 +/- 0.3 mm(2)). Coronary blood flow at baseline for patients in group 1 (with LVH) was significantly greater than it was for patients in groups 2 and 3 (81.1 +/- 9.9 ml/min, 56.5 +/- 6.2 ml/min and 48.1 +/- 3.2 ml/min, both p < 0.05). In comparison with groups 2 and 3, the response to both acetylcholine and adenosine was significantly impaired in patients with LVH.CONCLUSIONS The current study demonstrates that hypertension with LVH is associated with both coronary vascular remodeling and attenuated endothelial and nonendothelial coronary flow reserve. (C) 2000 by the American College of Cardiology.