Lack of Correlation Between Coronary Flow Reserve and Vascular Remodelling in Hypertensive Patients Without Left Ventricular Hypertrophy: An Optical Coherence Tomography Study

Introduction: This study aimed to evaluate the relationships between coronary flow reserve (CFR), coronary intima thickness (IT), and intima media thickness (IMT) in hypertensive patients. Methods: Thirteen consecutive, never-treated hypertensives (mean age 59.7 years, 6 men), without left ventricular hypertrophy and with angiographically normal coronary arteries, underwent CFR measurement in the left anterior descending artery in response to a bolus intracoronary administration of adenosine, together with an optical coherence tomography (OCT) study for the estimation of IT and IMT. Results: Hypertensive patients with a low CFR (<= 2.5, n=5) compared to those with a normal CFR (>2.5, n=8) exhibited significantly greater aortic pulse pressure (79.2 vs. 59.4 mmHg, p=0.01), while there was no difference with respect to age, sex, or left ventricular mass index (p=NS). Moreover, no difference was found between patients with low and normal CFR as regards maximal IT and IMT, or mean IT and IMT (p=NS for all). In the entire population, CFR exhibited no relationship with IT and IMT (p=NS). Finally, hypertensives with a low CFR compared to those with a normal CFR exhibited a trend towards a smaller left anterior descending area (7.8 vs. 9.5 mm(2), p=0.24). Conclusions: In hypertensive patients without left ventricular hypertrophy, adverse functional microcirculatory changes assessed by CFR are not accompanied by OCT-estimated alterations in coronary IT and IMT.