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

Relationship between changes in myocardial mass and perfusion were studied in 15 patients with stage II of essential hypertension with episodes of silent ischemia on Holter or exercise ECG and without coronary atherosclerosis at angiography. Echocardiography and myocardial scintigraphy with Tl-201 were performed before and after 1 year of treatment which resulted in hypotensive effect in all patients. In a year a decrease of left ventricular myocardial mass (LVMM) occurred in 5 patients. In 10 patients LVMM increased or remained unchanged. On initial scintigrams all patients had transitory perfusion defects without clearance disturbances. After 1 year in patients with decreased LVMM no transitory 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 of clearance. In patients with essential hypertension regression of myocardial hypertrophy leads to increase in myocardial perfusion reserve.