Abstract 11848: Relationships Between Coronary Microcirculation and Albuminuria Levels in Untreated Hypertensives
Purpose: Coronary flow reserve (CFR) is impaired in patients with essential hypertension. Our aim was to investigate the associations between CFR and cardiac and renal damage in untreated hypertensives.
Methods: For this purpose, we studied 21 hypertensive patients (aged 58.2 years, 8 males, office BP 150/95mmHg) with clinical indications of myocardial ischemia and normal coronary arteries in coronary angiography. CFR was calculated by a 0.014 in. Doppler flow wire (Flowire, Volcano) in the left anterior descending artery in response to bolus intracoronary administration of adenosine (60μ g) as the ratio of hyperemic to basal average peak velocity of the distal vessel. All the participants underwent complete echocardiographic study including left ventricular diastolic function evaluation by means of transmitral flow (E, A, E/A ratio) and tissue Doppler imaging (Em, Am) and determination of albumin to creatinine ratio (ACR) on two non-consecutive morning spot urine samples
Results: Based on a cut-off value of 2.5 for CFR, patients were classified into those with high (n=9) and low (n=12) CFR. Hypertensives with low CFR compared to those with high CFR decreased transmitral E/A (0.85 vs. 1.12, p=0.043) and Em/Am (0.7 vs. 0.95, p=0.047), as well as increased heart rate (79.2 vs 69.3 bpm, p=0.032) and aortic pulse pressure measured during catheterization (76.5 vs. 58.8 mmHg, p=0.003). ACR values were also significantly increased in patients with low compared to those with high CFR (29.1 vs. 9 mg/g, p=0.007). CFR was negatively correlated with ACR (r=−0.458, p=0.047), aortic pulse pressure (r=−0.675, p=0.001) and heart rate (r=−0.644, p=0.002) measured during catheterization.
Conclusions: Untreated hypertensives with impaired CFR are characterized by increased urine albumin excretion rate. These findings further support the concept for a parallel diffuse microcirculatory dysfunction in hypertension.
- © 2011 by American Heart Association, Inc.