Abstract
Objective: Left ventricular hypertrophy (LVH) and coronary atherosclerosis are common cardiac complications of hypertension. Previous studies have shown that LVH is associated with increased cardiovascular mortality, regardless of coronary artery disease. The purpose of this study was to evaluate the relationship between LVH and significant coronary arterial stenosis in hypertensive women with chest pain. Design and Method: One hundred ninety four hypertensive women with eligible data from the Korean women's chest pain registry (KoROSE) study were included. We analyzed echocardiographic data, demographic information, risk factors for cardiovascular disease, medical history, medication, and biochemical data. Patients with history of arrhythmia or significant valvular heart disease were excluded. LVH was defined if left ventricular mass index (LVMI) normalized by body surface area was more than 95 g/m2. Significant coronary arterial stenosis was defined as ≥50% luminal obstruction at least in one major epicardial coronary artery. Results: LVH group (n = 108) showed higher prevalence of significant coronary arterial stenosis compared with group without LVH (n = 86) (67.1% vs. 50.0%, p = 0.035). Body weight, height, blood pressure (BP), and lipid profile and hematologic findings were not significantly different between two groups. Total duration of exercise and the amount of work were not significantly different between two groups. However, LVH group showed higher diastolic BP at peak exercise in treadmill exercise test (85.4 mmHg vs. 77.1 mmHg, p = 0.003). Left ventricular ejection fraction (LVEF) was lower and parameters of diastolic function such as left atrial size were distorted in LVH group (p < 0.05). LVMI was correlated with LVEF and diastolic parameter. LVH was a predictor of significant coronary arterial stenosis (Odds ratio 2.037, 95% confidence interval = 1.066–3.894). Conclusions: LVH defined by LVMI is associated with higher prevalence of significant coronary arterial stenosis in hypertensive women with chest pain.
Published Version
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