LEFT-VENTRICULAR DIASTOLIC FUNCTION IN HYPERTENSIVE PATIENTS WITH UNSTABLE ANGINA AND SINGLE CORONARY-ARTERY DISEASE

The present study was performed to investigate left ventricular diasto lic (LVD) function in hypertensive patients with unstable angina. Thre e groups of 17 patients each were studied. Group 1 consisted of hypert ensives with unstable angina (HTU); group 2, normotensives with unstab le angina (NTU); and group 3, untreated, uncomplicated hypertensives ( HT). The LVD function was assessed echocardiographically by transmitra l valve Doppler flow to measure the ratio between the early diastolic filling (E) and the atrial contraction phase (A). An E/A ratio of <1 w as suggestive of LVD dysfunction. Left ventricular mass (LVM), from an M-mode echocardiogram using the Penn-Cube formula, was corrected to b ody surface area (LVM/S) using a standard nomogram. Data are represent ed as median values and analyzed by Mann-Whitney test. P was significa nt at <.05. The HTU group had an E/A ratio of 0.8, and the NTU and HT groups had ratios of 1.17 a,nd 1.1, respectively. There was significan t diastolic dysfunction in the HTU group compared with the NTU and HT groups (P = .037 and .049, respectively). Although the LVM/S was signi ficantly higher in the HTU group when compared with the HT group (110. 6 and 96.9, respectively, P = .017), there was no significant differen ce between the HTU and NTU groups (123.1), P = .67. Hypertensive patie nts with unstable angina have significant LVD dysfunction that seems i io be independent of LVM and ischemia. This may be attributable to inc reased stiffness of the left ventricle or structural left ventricular abnormalities.