STRESS ECHOCARDIOGRAPHIC ANALYSIS OF WALL -MOTION - PRESSORY STRESS IN HYPERTONICS WITH TYPICAL ANGINA-PECTORIS AND NEGATIVE CORONARY ANGIOGRAPHY

Patients with arterial hypertension and angina pectoris, but normal co ronary angiography have a normal regional and global systolic function during dobutamine-methoxamine stress echocardiography. Mean systolic diameters decrease from 3.37 +/- 0.67 to 2.44 +/- 0.59 cm with dobutam ine and show a slight increase to 2.78 +/- 0.68 cm after intravenous m ethoxamine. Diastolic diameters react similarly. Systolic wall thickne ss increases with doubutamine with a slight decrease immediately after methoxamine. Diastolic wall thickness also increases: from 1.01 +/- 0 .18 to 1.26 +/- 0.22 cm with dobutamine 40 mug/kg KG/min. This may hin t at an altered diastolic function in arterial hypertension. Normal sy stolic function excludes a functionally relevant microangiopathy. Cont rary to normal systolic function, ECG shows alterations typical of cor onary artery disease in 90% of the patients. Dobutamine-methoxamine st ress echocardiography may be a promising noninvasive method in patient s with thoracic pain.