Key result
In patients with stage I arterial hypertension and intact coronary arteries, myocardial ischemia was associated with significantly decreased left ventricular peak volume filling rate during stress compared to healthy controls.
Why the study?
To evaluate the correlation between quantitative perfusion parameters and diastolic function using 99mTc-SPECT/CT in patients with stage 1 arterial hypertension, chest pain, and intact coronary arteries.
Does stage I arterial hypertension with intact coronary arteries impact myocardial perfusion and diastolic function compared to healthy controls?
Cross-Sectional (n=40)
No
Does stage I arterial hypertension with intact coronary arteries impact myocardial perfusion and diastolic function compared to healthy controls?
Absolute Event Rate: 1.76% vs 2.77%
p-value: p=0.000009
Early-stage hypertension without left ventricular hypertrophy is associated with microvascular dysfunction, predisposing patients to stress-induced myocardial ischemia and diastolic dysfunction.
May indicate early stress-induced diastolic impairment in stage I hypertension; hypothesis-generating and requires prospective validation before clinical adoption.
Objective: to study the correlation between quantitative perfusion parameters and the diastolic function in patients with microvascular dysfunction and arterial hypertension, stage 1, pain in the left half of the chest and intact coronary arteries (ICA), according to the single-photon emission computed tomography with 99mTc. Material and methods. The study included 29 patients with stage I arterial hypertension confirmed by 24-hour blood pressure monitoring, without left ventricular hypertrophy, with pain in the left half of the chest and ICA, each of whom underwent diagnostic invasive coronary angiography and SPECT/CT of the myocardium with 99mTc-technetrile at rest and in combination with stress. Results. In the examined patients with stage I arterial hypertension, without left ventricular hypertrophy with pain in the left half of the chest and ICA, according to S-SPECT/CT, disturbances in diastolic function (DF) of the LV, heterogeneity of perfusion at rest and stress-induced myocardial ischemia, corresponding to the initial manifestations of coronary insufficiency, were revealed, caused by a decrease in the perfusion reserve due to secondary microvascular dysfunction (vMSD), and is, apparently, the main factor in the occurrence of pain in the left half of the chest in this category of patients. A reliable inverse relationship has been established between speed and direct time indicators of LV DF and the prevalence and severity of stress-induced myocardial ischemia. Conclusion. In patients with stage I arterial hypertension, without left ventricular hypertrophy with pain in the left half of the chest and ICA perfusion deficiency and myocardial ischemia are associated with a significant increase in diastolic duration and a decrease in the velocity parameters of LV DF, which is revealed by SPECT/CT data already in the early stages and initial stage of the HD disease. The occurrence of left-sided heart failure in patients with hypertension and ICA is associated with coronary insufficiency caused by vMSD.
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Khachirova et al. (2024) conducted a cross-sectional in Stage 1 arterial hypertension with chest pain and intact coronary arteries (n=40). Stage 1 arterial hypertension and microvascular dysfunction vs. Healthy controls was evaluated on Peak volume filling rate of left ventricle during stress (sPFR) (p=0.000009). In patients with stage I arterial hypertension and intact coronary arteries, myocardial ischemia was associated with significantly decreased left ventricular peak volume filling rate during stress compared to healthy controls.
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