Evaluation of the endothelial function in hypertensive patients with 13N-ammonia PET.
BACKGROUND
Essential hypertension is one of the main risk factors for the development of coronary artery disease (CAD). Hypertension causes endothelial dysfunction which is considered an early sign for the development of CAD. Positron emission tomography is a non-invasive imaging technique that measures myocardial blood flow (MBF), allowing us to identify patients with endothelial dysfunction.


RESULTS
19 patients without comorbidities recently diagnosed hypertensive, as well as 21 healthy volunteers were studied. A three-phase (rest, cold pressor test, and adenosine-induced hyperemia) (13)N-ammonia PET was performed, and MBF was measured. Endothelial-Dependent Vasodilation Index, ΔMBF, and coronary flow reserve (CFR) were calculated for each patient. Hypertensive patients had a significantly higher systolic and diastolic blood pressures compared with the control group (134.6 ± 11.7/86.4 ± 10.6 mm Hg and 106.0 ± 11.8/71.4 ± 6.6 mm Hg, respectively, P < .001). The ENDEVI (1.28 ± 0.26 vs 1.79 ± 0.30, P < .001), the ΔMBF (0.81 ± 0.50 vs 0.25 ± 0.21, P < .001) and the CFR (2.18 ± 0.88 vs 3.17 ± 0.68, P = .001) were significantly lower in the hypertensive patients compared to the control group, 84% of the former group had endothelial dysfunction i.e., ENDEVI < 1.5 and 58% had vasomotor abnormalities, i.e., CFR < 2.5.


CONCLUSIONS
In this study, we showed that recently diagnosed hypertensive patients have coronary endothelial dysfunction and vasomotor disturbances which are early signs for the development of CAD.
Unidad PET/CT Ciclotrón, Facultad de Medicina, Universidad Nacional Autónoma de México, Edificio de Investigación, Planta Baja, Ciudad Universitaria, CP 04510, Mexico City, DF, Mexico. alexanderick@yahoo.com
Erick
E
Alexánderson
Rodrigo
R
Jácome
Moisés
M
Jiménez-Santos
Juan Manuel
JM
Ochoa
Edgar
E
Romero
Marco Antonio Peña
MA
Cabral
Alejandro
A
Ricalde
Fernando
F
Iñarra
Aloha
A
Meave
Graciela
G
Alexánderson
D000328:Adult; D000368:Aged; D000641:Ammonia; D016022:Case-Control Studies; D003326:Coronary Circulation; D004730:Endothelium, Vascular / Q000503:physiopathology*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000000981:diagnostic imaging / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009590:Nitrogen Radioisotopes; D049268:Positron-Emission Tomography / Q000379:methods*; D011446:Prospective Studies; D017382:Reactive Oxygen Species / Q000378:metabolism
D009590:Nitrogen Radioisotopes; D017382:Reactive Oxygen Species; D000641:Ammonia