Unidad PET/CT Ciclotrón, Facultad de Medicina, Universidad Nacional Autónoma de México, Edificio de Investigación, Planta Baja, Ciudad Universitaria, CP 04510, Mexico City, DF, Mexico.
J Nucl Cardiol. 2012 Oct;19(5):979-86. doi: 10.1007/s12350-012-9584-z. Epub 2012 Jun 12.
Essential hypertension is one of the main risk factors for the development of coronary artery disease (CAD). Hypertension causes endothelial dysfunction which is considered an early sign for the development of CAD. Positron emission tomography is a non-invasive imaging technique that measures myocardial blood flow (MBF), allowing us to identify patients with endothelial dysfunction.
19 patients without comorbidities recently diagnosed hypertensive, as well as 21 healthy volunteers were studied. A three-phase (rest, cold pressor test, and adenosine-induced hyperemia) (13)N-ammonia PET was performed, and MBF was measured. Endothelial-Dependent Vasodilation Index, ΔMBF, and coronary flow reserve (CFR) were calculated for each patient. Hypertensive patients had a significantly higher systolic and diastolic blood pressures compared with the control group (134.6 ± 11.7/86.4 ± 10.6 mm Hg and 106.0 ± 11.8/71.4 ± 6.6 mm Hg, respectively, P < .001). The ENDEVI (1.28 ± 0.26 vs 1.79 ± 0.30, P < .001), the ΔMBF (0.81 ± 0.50 vs 0.25 ± 0.21, P < .001) and the CFR (2.18 ± 0.88 vs 3.17 ± 0.68, P = .001) were significantly lower in the hypertensive patients compared to the control group, 84% of the former group had endothelial dysfunction i.e., ENDEVI < 1.5 and 58% had vasomotor abnormalities, i.e., CFR < 2.5.
In this study, we showed that recently diagnosed hypertensive patients have coronary endothelial dysfunction and vasomotor disturbances which are early signs for the development of CAD.
原发性高血压是冠状动脉疾病（CAD）发展的主要危险因素之一。高血压引起内皮功能障碍，被认为是 CAD 发展的早期迹象。正电子发射断层扫描是一种非侵入性成像技术，可测量心肌血流（MBF），使我们能够识别出内皮功能障碍的患者。
研究了 19 名近期诊断为高血压且无合并症的患者和 21 名健康志愿者。进行了三相（休息、冷加压试验和腺苷诱导性充血）（13）N-氨正电子发射断层扫描，并测量了 MBF。为每位患者计算了内皮依赖性血管舒张指数、ΔMBF 和冠状血流储备（CFR）。与对照组相比，高血压患者的收缩压和舒张压明显更高（分别为 134.6 ± 11.7/86.4 ± 10.6mmHg 和 106.0 ± 11.8/71.4 ± 6.6mmHg，P <.001）。ENDEVI（1.28 ± 0.26 比 1.79 ± 0.30，P <.001）、ΔMBF（0.81 ± 0.50 比 0.25 ± 0.21，P <.001）和 CFR（2.18 ± 0.88 比 3.17 ± 0.68，P =.001）在高血压患者中明显低于对照组，前者组中 84%的患者存在内皮功能障碍，即 ENDEVI < 1.5，58%的患者存在血管运动异常，即 CFR < 2.5。
在这项研究中，我们表明，近期诊断的高血压患者存在冠状动脉内皮功能障碍和血管运动障碍，这是 CAD 发展的早期迹象。
