Abstract
In this study, our aim was to assess the coronary flow reserve (CFR) by performing the adenosine stress (99m)Tc-MIBI single-photon computed tomographic (SPECT) myocardial perfusion imaging in patients with hypertension. 47 hypertensive patients with normal coronary angiography were divided into 2 groups, defined by the presence (LVH, n=22) and absence (non-LVH, n=25) of left ventricular hypertrophy with 17 normal cases as controls. All patients were administered the adenosine stress-rest (99m)Tc-MIBI scintigraphy. 0.14mg/kg/min adenosine was administered by continuous infusion for 6min. We found that adenosine-induced myocardial ischemia was present in 26 cases (55.3%) with 87 segments (20.6%) showing abnormal distribution in the hypertensive group versus a single case (5.9%) (χ (2)=31.12, P<0.001) and segment (0.7%) (χ (2)=32.90, P<0.001) in the control group by SPECT perfusion. In the LVH group, 17 cases (77.3%) and 67 segments (33.8%) of myocardial ischemia were present. In the non-LVH group, there were 9 cases (36.0%) (χ (2)=8.06, P<0.001), 20 segments (8.9%) (χ (2)=40.13, P<0.001). There was a significant decrease in coronary reserve in the hypertensive groups following adenosine infusion with a fourfold decrease in cases and a sixfold decrease in segments (P<0.001). Our study suggests that assessing CFR by the (99m)Tc-MIBI adenosine stress by SPECT imaging is a relatively easy, safe, and non-invasive test in patients with hypertension. We noted a decrease in CFR in patients with hypertension. This decrease was especially remarkable for hypertensive patients with LVH. This study shows that administering the (99m)Tc-MIBI adenosine stress by SPECT imaging is a safe, simple, and non-invasive test for detecting CFR in patients with hypertension.
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