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Hypertension, Left Ventricular Hypertrophy, and Coronary Flow Reserve

  • Edward D. Frohlich
Chapter
Part of the Advances in Experimental Medicine and Biology book series (AEMB, volume 432)

Abstract

The increased independent risk for premature cardiovascular mortality related to left ventricular hypertrophy (LVH) may be attributed to a number of underlying pathophysiological alterations(1). Among the postulated mechanisms are: an intrinsic pathological defect inherent with the hypertrophied myocardium, per se; impaired ventricular pumping ability that may exacerbate decompensation; co-existent diseases of the left ventricle (e.g., occlusive epicardial artery atherosclerosis, exogenous obesity, diabetes mellitus); increased myocardial irritability that predisposes to sudden cardiac death; co-existing pharmacological therapy; and impaired coronary hemodynamics including coronary blood flow reserve. A number of current investigations are focusing on the possibility that reduced coronary blood flow and flow reserve predispose the hypertensive patient with LVH to premature mortality. Those factors that may participate in potentially lethal ischemia include: reduced basal coronary blood flow and coronary flow reserve; increased coronary vascular resistance and minimal coronary vascular resistance; reduced vasodilating capability of the hypertensive coronary arterioles (e.g., from reduced endothelial synthesis of nitric oxide and other substances); and altered blood viscosity in the coronary microcirculation.

Keywords

Left Ventricular Hypertrophy Left Ventricular Mass Coronary Flow Reserve Coronary Blood Flow Coronary Vascular Resistance 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer Science+Business Media New York 1997

Authors and Affiliations

  • Edward D. Frohlich
    • 1
  1. 1.Alton Ochsner Medical FoundationNew OrleansUSA

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