ABNORMAL CORONARY FLOW RESERVE IN PATIENTS WITH ANGINA-PECTORIS AND HYPERTENSIVE LEFT-VENTRICULAR HYPERTROPHY

Objective. To assess coronary flow reserve using a computer-assisted m ethod with intracoronary papaverine in patients with angina pectoris. Patients and Methods. Coronary arterial diameter, cross-sectional area and blood flow velocity were measured during coronary arteriography b efore and after intracoronary papaverine in 26 control subjects, 45 pa tients with significant coronary artery disease (>50% luminal narrowin g), 16 patients with syndrome X and 14 patients with hypertension and left ventricular hypertrophy(LVH). Results. After intracoronary admini stration of papaverine, proximal diameter, cross-sectional area, blood velocity, flow volume and reserve capacity of both left anterior desc ending and right coronary arteries were lower in patients with signifi cant coronary stenosis than in the controls. Despite similar changes i n diameter and cross-sectional area, the blood velocity, flow volume a nd reserve capacity of the two Vessels were also lower in patients wit h syndrome X than in the controls. In 14 patients with hypertension an d LVH, although the blood velocity and now volume were augmented for t he two arteries and did not differ from those in the controls, the flo w reserve was reduced because of higher baseline blood velocity and fl ow volume. Conclusions. Coronary flow reserve is reduced in patients w ith coronary artery disease, syndrome X or hypertensive LVH, which may be related to abnormal changes at different levels of the coronary va sculature or resting flow states.