P-398: Relationship between reduced exercise tolerance and cardiac functional and structural factors in hypertensive patients without coronary artery disease

Exercise tolerance (ET) has been found impaired in hypertensive patients compared to normotensive controls, even in absence of angiographically significant CAD and detectable myocardial ischemia. Such an impairment can be supposed to depend on several factors as coronary flow reserve (CFR), the hemo...

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Published in:American journal of hypertension 2001-04, Vol.14 (S1), p.164A-164A
Main Authors: Bigalli, Giovanni, Kozakova, Michaela, Emdin, Michele, Morizzo, Carmela, Magagna, Armando, Nassi, Guido, L'Abbate, Antonio, Palombo, Carlo
Format: Article
Language:English
Subjects:
Coronary flow reserve
Exercise tolerance
left ventricular geometry
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Summary:Exercise tolerance (ET) has been found impaired in hypertensive patients compared to normotensive controls, even in absence of angiographically significant CAD and detectable myocardial ischemia. Such an impairment can be supposed to depend on several factors as coronary flow reserve (CFR), the hemodynamic response to exercise, and LV mass and dimension. Aim of this study was to investigate the relative role of CFR, LV chamber dimension, heart rate (HR) and systolic blood pressure (SBP) response to exercise, on ET in hypertensive and normotensive subjects. Methods: 40 patients with mild-moderate untreated essential HBP and 20 normotensive controls (NT) of similar age, with chest pain syndrome and angiographically normal coronary arteries, underwent: maximal cycloergometer exercise test with stepwise increments of 25 W every 2 minutes, until exhaustion, with continuous 12-lead ECG and blood pressure monitoring; M-mode echo, to measure LV dimension; transesophageal echo-Doppler, in basal condition and during i.v. adenosine infusion (140 μg/Kg/min in 5 min), to monitor coronary flow velocity (CFV) in left anterior descending artery. The adenosine/basal CFV ratio was computed as an index of CFR. Results: in both HBP patients and NT, exercise tests were negative for myocardial ischemia at a similar age-adjusted maximal HR (89±11 vs. 91±10%) and rate-pressure product (29658±6201 vs. 28826±4841 bpm*mmHg). HBP patients, compared to NT, showed a significantly (p
ISSN:0895-7061
1941-7225
1879-1905
DOI:10.1016/S0895-7061(01)01556-4