Hypertension impairs myocardial blood perfusion reserve in subjects without regional myocardial ischemia.

Hypertens Res 2010 Nov 5;33(11):1144-9. Epub 2010 Aug 5.

Department of Cardiology, Mie University Graduate School of Medicine, Tsu, Japan.

Quantitative analysis of myocardial perfusion MRI can provide noninvasive assessments of myocardial perfusion reserve (MPR), which is associated with endothelial function. Endothelial function is influenced by various factors, including hypertension, diabetes, dyslipidemia, renal dysfunction and anemia. The purpose of this study was to evaluate which risk factor is the strongest effector of MPR in subjects without regional myocardial ischemia. We studied 110 patients (66 years ±10, male 68%, hypertension 76%, diabetes mellitus (DM) 40% and dyslipidemia 65%) without regional myocardial ischemia. Adenosine triphosphate (ATP) stress and rest first-pass perfusion magnetic resonance (MR) images were acquired with a 1.5-T MR system, and MPR was calculated as the ratio of stress to rest myocardial blood flow (MBF). Average rest MBF in 110 patients was 1.07±0.62 ml min⁻¹ g⁻¹, whereas stress MBF was 3.15±1.93 ml min⁻¹ g⁻¹ and the MPR was 3.33±1.82. Rest MBF correlated significantly with hematocrit, whereas stress MBF showed a strong correlation with estimated glomerular filtration rate (e-GFR). MPR was associated with hypertension, age, e-GFR, hematocrit and left ventricular mass index (LVMI). In multiple regression analysis, hypertension (P=0.003, β=-0.274) showed the strongest correlation with MPR among other risk factors, such as diabetes (P=ns), dyslipidemia (P=ns), e-GFR (P=ns), LVMI (P=0.007, β=-0.248) and hematocrit (P=ns) after adjusting age and gender. Hypertension is the most important effector of MPR in subjects without myocardial ischemia.

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http://dx.doi.org/10.1038/hr.2010.140DOI Listing
November 2010
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References

(Supplied by CrossRef)

PG Camici et al.
N Engl J Med 2007

D Erdogan et al.
Circulation 2007

C Meyer et al.
Am J Cardiol 1997

OP Pitkanen et al.
J Am Coll Cardiol 1996

L Wang et al.
J Am Coll Cardiol 2006

T Kurita et al.
Eur Heart J 2009

H Sakuma et al.
Am J Roentgenol 2005

T Ichihara et al.
Magn Reson Med 2009

MA Costa et al.
J Am Coll Cardiol 2007

DC Lee et al.
Circulation 2004

M Jerosch-Herold et al.
Med Phys 1998

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