ARTERIAL HYPERTENSION AND LEFT VENTRICLE FUNCTION IN PATIENTS WITH ISOLATED LEFT ANTERIOR DESCENDING ARTERY DISEASE: LONG TERM FOLLOW UP

Objective. Hypertension (HTN) is a well-known risk factor of coronary artery disease (CAD). Despite this, history of HTN was positively associated with collateral flow index. We analyzed left ventricle (LV) structure and function parameters among CAD patients with and without HTN.

 Design and methods. We included 93 patients with isolated left anterior descending artery disease (40 of them had chronic total occlusion, CTO). All patients had positive exercise stress echocardiography test with the ischemia in the left anterior descending artery (LAD) zone. Eighteen patients underwent left internal mammary artery to LAD grafting, 56 patients had percutaneous coronary intervention and 19 patients did not undergo revascularization. Mean follow-up period was 6 years. End-diastolic diameter, end-diastolic volume, end-systolic volume and LV ejection fraction (EF) were assessed. Exercise stress-echocardiography was performed and wall motion score index was estimated before and after the stress.

Results. End-systolic volume increased significantly in patients without HTN and did not change in hypertensive patients (p < 0,05). EF increased in hypertensive patients with CTO, in normotensives slight reduction was observed (p < 0,05). No significant differences of stress-echo parameters were found between the groups. Δ wall motion score index parameter significantly decreased in both groups (p < 0,05).

Conclusion. HTN is associated with preserved LV volume and EF among patients with isolated LAD disease.

hypertension, chronic occlusion, isolated disease of the left anterior descending artery

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