Coronary collateral blood-flow velocity improves with repeated coronary occlusions during angioplasty in patients with coronary artery disease and systemic hypertension.

BACKGROUND

Cardiac hypertrophy is associated with numerous alterations in the coronary circulation.

OBJECTIVE

To test the hypothesis that, during angioplasty, the coronary collateral blood flow during repetitive coronary occlusions increases more in hypertensives than it does in normotensives.

METHODS

We studied 34 patients (22 normotensives and 12 hypertensives) with stable angina and single-vessel disease undergoing coronary angioplasty during two similar balloon inflations. Each balloon inflation was maintained for 120 s. The coronary blood flow velocity was estimated using the Doppler-flow guide wire, which was positioned distally to the lesion. Flow velocities were recorded before balloon deflation.

RESULTS

The average peak velocity increased by 29.0 +/- 14.7 mm/s in the hypertensives and decreased by 9.4 +/- 4.9 mm/s in the normotensives (P < 0.01) during the second balloon inflation, whereas the velocity-time integral increased by 33.1 +/- 19.2 mm and decreased by 14.3 +/- 11.3 mm (P < 0.05), respectively. The ST-segment elevation decreased by 1.13 +/- 1.27 and by 0.17 +/- 0.16 mV, respectively (P = 0.01). The increase in the average peak velocity which occurred during the second balloon inflation was related to the left ventricular mass (r = 0.47, P = 0.004).

CONCLUSION

These results indicate that the coronary collateral blood flow velocity improves with repetitive coronary occlusions during angioplasty in patients with systemic hypertension and that this increase is correlated to the left ventricular mass.