MYOCARDIAL PERFUSION RESERVE AND MYOCARDI AL HYPERTROPHY IN PATIENTS WITH ESSENTIAL-HYPERTENSION AND SILENT ISCHEMIA

Relationship between changes in myocardial mass and perfusion were stu died in 15 patients with stage II of essential hypertension with episo des of silent ischemia on Holter or exercise ECG and without coronary atherosclerosis at angiography. Echocardiography and myocardial scinti graphy with Tl-201 were performed before and after 1 year of treatment which resulted in hypotensive effect in all patients. In a year a dec rease of left ventricular myocardial mass (LVMM) occurred in 5 patient s. In 10 patients LVMM increased or remained unchanged. On initial sci ntigrams all patients had transitory perfusion defects without clearan ce disturbances. After 1 year in patients with decreased LVMM no trans itory perfusion defects were found while in patients with unchanged or increased LVMM there were transitory perfusion defects which had the same location but became larger and were accompanied by disturbances o f clearance. In patients with essential hypertension regression of myo cardial hypertrophy leads to increase in myocardial perfusion reserve.