D'Errico, Arcangelo (2008) Associazione indipendente tra la riserva di flusso coronarico e le pressioni di riempimento e il rilasciamento del ventricolo sinistro. [Tesi di dottorato] (Inedito)

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Tipologia del documento: Tesi di dottorato
Lingua: Italiano
Titolo: Associazione indipendente tra la riserva di flusso coronarico e le pressioni di riempimento e il rilasciamento del ventricolo sinistro
Autori:
AutoreEmail
D'Errico, Arcangeloaxcangio@libero.it
Data: 2008
Numero di pagine: 28
Istituzione: Università degli Studi di Napoli Federico II
Dipartimento: Medicina clinica e sperimentale
Dottorato: Fisiopatologia clinica e medicina sperimentale
Ciclo di dottorato: 21
Coordinatore del Corso di dottorato:
nomeemail
Marone, Giannimarone@unina.it
Tutor:
nomeemail
De Divitiis, Oreste[non definito]
Data: 2008
Numero di pagine: 28
Parole chiave: Riserva di flusso coronarico, Geometria ventricolare sinistra, Doppler Tissutale, Rilasciamento miocardico, Pressioni di riempimento del ventricolo sinistro, Coronary flow reserve, Left ventricular geometry, Tissue Doppler, Myocardial relaxation, Left ventricular filling pressure
Settori scientifico-disciplinari del MIUR: Area 06 - Scienze mediche > MED/09 - Medicina interna
Depositato il: 09 Nov 2009 10:09
Ultima modifica: 02 Dic 2014 11:12
URI: http://www.fedoa.unina.it/id/eprint/3132
DOI: 10.6092/UNINA/FEDOA/3132

Abstract

Background: A cross-talk between coronary flow and left ventricular (LV) function is recognized. This study tested the hypothesis that impairment of coronary flow reserve (CFR) in arterial hypertension is associated with LV systolic and diastolic dysfunction, independently on abnormalities of LV geometry. Methods: We studied 59 newly diagnosed, never treated hypertensive patients, using transthoracic Doppler echocardiography, including pulsed Tissue Doppler of mitral annulus and CFR on left anterior descending artery (low dose dipyridamole). The study population was divided in 2 groups according to age-normalized relative wall thickness (RWTn): 36 with normal LV geometry (RWTn ≤ 0.41) and.23 patients with LV concentric geometry (RWTn > 0.41) Results: Patients with LV concentric geometry (RWTn > 0.41) had significantly lower midwall (but not endocardial) shortening, longer isovolumic relaxation time (IVRT), lower Tissue Doppler derived early diastolic velocity (Em), higher ratio of transmitral E velocity to Em and lower CFR than patients with normal LV geometry (RWTn ≤ 0.41). In the whole population lower CFR was significantly associated with lower midwall shortening and Em, longer IVRT and higher E/Em ratio. After controlling for heart rate, mean blood pressure and RWTn, only the relation of CFR with IVRT, Em and E/Em ratio remained significant. Conclusions: Reduced midwall mechanics is associated to lower CFR, a relation depending on LV concentric geometry. A reduced CFR is associated with both impaired relaxation and increased filling pressure, a relation that is independent on LV geometry and pressure load.

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