CORONARY COLLATERAL BLOOD-FLOW VELOCITY IMPROVES WITH REPEATED CORONARY OCCLUSIONS DURING ANGIOPLASTY IN PATIENTS WITH CORONARY-ARTERY DISEASE AND SYSTEMIC HYPERTENSION

Background Cardiac hypertrophy is associated with numerous alterations in the coronary circulation. Objective To test the hypothesis that, d uring angioplasty, the coronary collateral blood flow during repetitiv e coronary occlusions increases more in hypertensives than it does in normotensives. Methods We studied 34 patients (22 normotensives and 12 hypertensives) with stable angina and single-vessel disease undergoin g coronary angioplasty during two similar balloon inflations. Each bal loon inflation was maintained for 120 s. The coronary blood flow veloc ity was estimated using the Doppler-flow guide wire, which was positio ned distally to the lesion. Flow velocities were recorded before ballo on deflation. Results The average peak velocity increased by 29.0 +/- 14.7 mm/s in the hypertensives and decreased by 9.4 +/- 4.9 mm/s in th e normotensives (P<0.01) during the second balloon inflation, whereas the velocity-time integral increased by 33.1 +/- 19.2 mm and decreased by 14.3 +/- 11.3 mm (P<0.05), respectively. The ST-segment elevation decreased by 1.13 +/- 1.27 and by 0.17 +/- 0.16 mV, respectively (P = 0.01). The increase in the average peak velocity which occurred during the second balloon inflation was related to the left ventricular mass (r = 0.47, P = 0.004). Conclusion These results indicate that the cor onary collateral blood flow velocity improves with repetitive coronary occlusions during angioplasty in patients with systemic hypertension and that this increase is correlated to the left ventricular mass. (C) Rapid Science Publishers ISSN 0954-6928.