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Fractional pulse pressure as a simple index of impaired coronary flow reserve in hypertensive patients

By Ragab A. Mahfouz


Fractional pulse pressure (PPf), is thought to be more directly reflect arterial stiffness than pulse pressure. Our aim was to evaluate the relationship between coronary flow reserve (CFR) and PPf in hypertensive patients with normal coronary arteriesSubjects and methodsOne-hundred and six consecutive hypertensive patients (aged 52.8+9.4 years), with indications of myocardial ischaemia with exercise electrocardiogram (EECG) and normal coronary arteries in coronary angiography. CFR was calculated noninvasively using transthoracic echo-Doppler assessment with hyperemia induced by infusion of dipyridamole at a rate of 0.56mg/kg over 4min. PPf was calculated as pulse pressure divided by mean arterial pressure (SBP-DBP/MAP), while diastolic function was evaluated by means of transmitral flow and tissue Doppler imaging. Hypertensive patients with low CFR (n=54) compared with those with normal CFR (n=52) exhibited significantly incresed PPf (75.2±11.4 vs 64.5±6.7 P<0.001). In hypertensives with low CFR, CFR was negatively correlated with PPf (r=−0.651, P<0.0001). After applying multivariate linear regression analysis, age, left ventricular mass index, Em/Am, and PPf turned out to be independent predictors of CFR.ConclusionEstimation of PPf by using simple sphygmomanometer blood pressure measurement is simple non-invasive index for assessment of coronary microcirculation in essential hypertensive patients with indications of myocardial ischaemia and normal coronary arteries

Publisher: Production and hosting by Elsevier B.V.
Year: 2013
DOI identifier: 10.1016/j.jsha.2013.03.017
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