966-44 Conduit Coronary Artery Cross-sectional Area is Abnormal in Hypertensive Patients with Angina Pectoris and Normal Coronary Angiogram

• Published in: Journal of the American College of Cardiology 1995-02, Vol.25 (2), p.224A-225A
• Main Authors: Isaaz, Karl, Arguello, Fabrice, Ethevenot, Gérard, Aliot, Etienne
• Format: Article
• Language: English
• ISSN: 0735-1097; 1558-3597
• DOI: 10.1016/0735-1097(95)92392-I

The mechanisms of chest pain in patients with hypertension (H) and LV hypertrophy are still debated. In the present study, we analyzed the relation between epicardial coronary artery cross-sectional area (CSA) and LV mass in 34 H patients with normal coronary angiogram; 16 pts were asymptomatic (Ha) and 18 pts presented with typical angina pectoris (Hs). H pts data were compared to those obtained in 17 age-matched control subjects (N). Using a computer-based quantitative coronary angiographic system, proximal diameter and derived CSA (in mm2) of the left anterior descending (LAD) and left circumflex (CX) arteries were calculated from 2 orthogonal projections over a length of 1cm immediately beyond the bifurcation of the left main coronary artery. LV mass was calculated by M-mode echo using the methodology of the American Society of Echo corrected by the Devereux formula. Results:ILVM2h(mm)CSAtCSAt/ILVMCSAt/2hN84±1917±316±0.20±0.100.99±0.49Ha129±46*22±4*19±60.15±0.060.84±0.22Hs139±46*24±5*12±6*,#0.09±0.06*,#0.53±0.29*,#CSAt=[LAD + CX] CSA, ILVM=indexed LV mass in g/m2.2h=end-diastolic [septal + posterior] wall thickness*p<0.05 vs N#P<0.05 vs Ha A good linear correlation was found in Ha pts between CSAt and 2h (r=0.78, p=0.0004) resulting in a significant linear relation with LV mass (r=0.68, P=0.04). In Hs pts, no correlation was found between CSAt and LV wall thickness and LV mass. In hypertensive pts with angina pectoris and no significant focal stenosisat the angiogram, epicardial coronary arteries have smaller size than in normal subjects suggesting a diffuse narrowing of the vessel. In asymptomatic hypertensive pts proximal coronary arteries appear to increase proportionnally to the increase in LV mass, which may allow to maintain coronary flow velocity and shear stress constant.