CORONARY-ARTERY DIMENSIONS IN PRIMARY AND SECONDARY LEFT-VENTRICULAR HYPERTROPHY

Background. Coronary artery enlargement has been previously described in left ventricular hypertrophy. Objectives. We sought to assess coron ary artery dimensions and their relation to left ventricular muscle ma ss in primary and secondary hypertrophy. Methods. Cross-sectional area of the left and right coronary arteries was determined by quantitativ e coronary angiography in 52 patients: 12 control subjects and 40 pati ents (13 with hypertrophic cardiomyopathy, 12 with dilated cardiomyopa thy and 15 with aortic valve disease). As a measure of left ventricula r hypertrophy, angiographic left ventricular mass and equatorial cross -sectional muscle area were determined. Results. Cross-sectional area of both the left and right coronary arteries is increased in left vent ricular hypertrophy (p < 0.05 vs. values in control subjects), There i s a curvilinear relation between left coronary artery size and left ve ntricular muscle mass (r = 0.76) or cross sectional muscle area (r = 0 .75), However, normalization of coronary cross-sectional area for left ventricular muscle mass or muscle area shows insufficient enlargement of the coronary arteries in both primary and secondary hypertrophy. C onclusions. 1) Coronary artery size increases as left ventricular mass increases in both primary and secondary hypertrophy. 2) The enlargeme nt of left coronary cross sectional area is independent of the cause o f the increase in left ventricular mass. 3) The size of the coronary a rteries is inappropriate with regard to left ventricular hypertrophy, Thus, the stimulus for growth of the coronary arteries is not influenc ed by the underlying disease but appears to depend on the degree of le ft ventricular hypertrophy.