[Left ventricular hypertrophy secondary to systemic hypertension: its effect on coronary hemodynamics].
To clarify the characteristics and possible causes of phasic blood velocity patterns in pressure overload hypertrophy, we measured blood flow velocities in the left anterior descending coronary arteries in 16 patients with left ventricular hypertrophy secondary to systemic hypertension. These measurements were made with a 20MHz Doppler catheter. All patients had normal coronary arteriograms. The blood flow velocity patterns were characterized by the decrease in the rise of early diastolic inflow velocity. Prolongation in the time from the onset of diastole to peak velocity (TDPV) correlated with the degree of left ventricular hypertrophy. TDPV was prolonged in proportion to the increase in the peak left ventricular systolic pressure and left ventricular ejection fraction. The flow reserve calculated from the ratio of the diastolic mean velocity after the intracoronary injection of papaverine to the resting flow showed a trend toward the decrease proportional to the prolongation in TDPV due to an increase of wall thickness. In conclusion, preceding systolic vascular compression and systolic vascular strain can be factors causing early diastolic inflow disturbance in left ventricular hypertrophy secondary to hypertension. The decrease of coronary reserve may partially be attributable to the decrease in the rise of early diastolic inflow velocity.
Tadaoka
S
S
Department of Medicine, Kawasaki Medical School, Kurashiki.
Wada
Y
Y
Kimura
A
A
Yada
T
T
Tanaka
J
J
Hasegawa
K
K
Nezuo
S
S
Sawayama
T
T
Tsujioka
K
K
Kajiya
F
F
D000328:Adult; D000368:Aged; D001783:Blood Flow Velocity; D006328:Cardiac Catheterization; D006332:Cardiomegaly / Q000209:etiology / Q000503:physiopathology*; D003326:Coronary Circulation; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged