Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Coronary microcirculation into different models of left ventricular hypertrophy—hypertensive and athlete's heart: a contrast echocardiographic study

Journal of Human Hypertension volume 17, pages 253–263 (2003)Cite this article

Abstract

The study was carried out in two different models of left ventricular hypertrophy: athlete's heart and essential arterial hypertension. Three groups of strictly age-matched males were studied: one group of 10 young adult untreated essential hypertensive patients (H), a second group of 10 athletes (A), and a group of 10 healthy individuals as controls (C). A Sonos 5500 echograph with S4 harmonic transducer was used with Levovist (ultrasonic tracer) before and after dipyridamole injection; digitised images of quantitative myocardial contrast echocardiography were collected with Power Harmonic Doppler. Angio images were analysed using dedicated PC software by placing a region-of-interest on the septum. Peak intensity, half-time (HT), the area under the curve of appearance and disappearance of microbubbles at 2/3 of PI, both in absolute and indexed values (/LVMi), were sampled. The per cent increase of PI after dipyridamole was significantly higher in C (+73%, P<0.01) than in H (+31%) and in A (+33%) (P<0.05). The area of appearance was significantly lower in H in comparison with C and A, both at rest and after vasodilatation. The disappearance area after dipyridamole was signifi-cantly higher in C and in A (+124%) than in H (+104%) (P<0.05). Some hypothesis could be made: an impairment in the coronary microcirculatory function in hypertensive patients could be because of an in-crease in the arteriolar resistance. Angiogenesis and several different functional adaptations are the mecha-nisms that allow an optimal distribution of oxygen and of substrates to the hypertrophied myocardium of the athletes.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1
Figure 2

Similar content being viewed by others

References

  1. Mayet J, Foale RA . Changes in left ventricular function in cardiac hypertrophy. In: Sheridan DJ (ed). Left Ventricular Hypertrophy. Churchill Livingstone: London, 1998, pp 93–98.

    Google Scholar 

  2. Cooklin M, Wallis WRJ, Sheridan DJ, Fry CH . Changes to cell-to-cell electric coupling associated to left ventricular hypertrophy. Circ Res 1997; 80: 765–771.

    Article  CAS  Google Scholar 

  3. Sheridan DJ, Kingsbury MP . Mechanisms of reduced coronary reserve in cardiac hypertrophy. In: Sheridan DJ (ed). Left Ventricular Hypertrophy. Churchill Livingstone: London, 1998, pp 135–143.

    Google Scholar 

  4. Colan SD, Sanders SP, MacPerson D, Borow KM . Left ventricular diastolic function in elite athletes with physiologic left ventricular hypertrophy. J Am Coll Cardiol 1985; 6: 545–549.

    Article  CAS  Google Scholar 

  5. McAinsh AM et al. Cardiac hypertrophy impairs recovery from ischemia because there is a reduced reactive iperaemic response. Cardiovasc Res 1995; 30: 113–121.

    Article  CAS  Google Scholar 

  6. Laine H et al. Early impairment of coronary flow reserve in young men with borderline hypertension. J Am Coll Cardiol 1998; 32: 147–153.

    Article  CAS  Google Scholar 

  7. Pedrinelli R et al. Myocardial and forearm blood flow reserve in mild–moderate essential hypertensive patients. J Hyperten 1997; 15: 667–673.

    Article  CAS  Google Scholar 

  8. Dayanikly F et al. Early detection of abnormal coronary flow reserve in asymptomatic men at high risk for coronary artery disease using positron emission tomography. Circulation 1994; 90: 808–817.

    Article  Google Scholar 

  9. Hamasaki S et al. Attenuated coronary flow reserve and vascular remodeling in patients with hypertension and left ventricular hypertrophy. J Am Coll Cardiol 2000; 35: 1654–1660.

    Article  CAS  Google Scholar 

  10. Uhlendorf V, Scholle F-D . Imaging of spatial distri-bution and flow of microbubbles using non-linear acoustic properties. Acoust Imag 1996; 22: 233–238.

    Article  Google Scholar 

  11. Jayaweera A et al. Role of capillaries in determining CBF reserve: new insights using myocardial contrast echocardiography. Am J Physiol 1999; 277: H2363–H2372.

    CAS  PubMed  Google Scholar 

  12. Joint National Committee on Detection, Evaluation and Treatment of High Blood Pressure. The fifth report of the Joint National Committee on Detection, Evaluation and Treatment of High Blood Pressure (JNC V). Arch Int Med 1993; 153: 154–183.

  13. Devereux RB et al. Standardization of M-Mode echocardiographic left ventricular anatomic measurements. J Am Coll Cardiol 1984; 4: 1222–1230.

    Article  CAS  Google Scholar 

  14. Taylor KJ, Burns PN, Wells PNT . Clinical Application of Doppler Ultrasound. Raven Press: New York, 1996.

    Google Scholar 

  15. Becker H . Second harmonic imaging with Levovist: initial clinical experience. Second European Symposium on Ultrasound Contrast Imaging, Erasmus University Rotterdam, 1997.

  16. Burns PN et al. Harmonic contrast enhanced Doppler as a method for the elimination of clutter—In vivo duplex and color studies. Radiology 1993; 189: 285.

    Article  Google Scholar 

  17. Di Bello V et al. The role of quantitative myocardial contrast echocardiography in the study of coronary microcirculation in athlete's heart. J Am Soc Echo-cardiogr 2002; 15: 678–685.

    Article  Google Scholar 

  18. Bland JM, Altmann DG . Measurement error and correlations coefficients. BMJ 1996; 313: 41–42.

    Article  CAS  Google Scholar 

  19. Hoffman JIE . Maximal coronary flow and concept of coronary vascular reserve. Circulation 1984; 70: 153–159.

    Article  CAS  Google Scholar 

  20. Pijls NH et al. Measurement of fractional flow reserve to assess the functional severity of coronary-artery stenoses. N Engl J Med 1996; 334: 1703–1708.

    Article  CAS  Google Scholar 

  21. Flannery BP et al. Three-dimensional X-ray micro tomography. Science 1987; 237: 1439–1444.

    Article  CAS  Google Scholar 

  22. Jones CJH et al. Myogenic and flow-dependent control mechanisms in the coronary microcirculation. Basic Res Cardiol 1993; 88: 2–10.

    CAS  PubMed  Google Scholar 

  23. Hoffman JIE . Maximal coronary flow and the concept of coronary vascular reserve. Circulation 1984; 70: 153–159.

    Article  CAS  Google Scholar 

  24. Jones CJH, Kuo L, Davis MJ, Chilian W . Regulation of coronary blood flow: coordination of heterogeneous control mechanisms in vascular microdomains. Cardiovasc Res 1995; 29: 585–596.

    Article  CAS  Google Scholar 

  25. Chilian WM et al. Small vessel phenomena in the coronary microcirculation: phasic intramyocardial perfusion and microvascular dynamics. Prog Cardiovasc Dis 1988; 31: 17–38.

    Article  CAS  Google Scholar 

  26. Leipert B, Becker BF, Gerlach E . Different endo-thelial mechanisms involved in coronary responses to known vasodilatators. Am J Physiol 1992; 162: H1676–H1683.

    Google Scholar 

  27. Mayhan WG . Endothelium-dependent responses of cerebral arterioles to adenosine 5'-diphosphate. J Vasc Res 1992; 29: 353–358.

    Article  CAS  Google Scholar 

  28. Marcus ML et al. Understanding the coronary circu-lation through studies at the microvascular level. Circulation 1990; 82: 1–7.

    Article  CAS  Google Scholar 

  29. Vogt M, Motz W, Strauer BE . Coronary hemodynamics in hypertensive heart disease. Eur Heart J 1992; 13 (Suppl D): 44–49.

    Article  Google Scholar 

  30. Houghton JL et al. Heterogeneous vasomotor responses of coronary conduit and resistance vessels in hypertension. J Am Coll Cardiol 1998; 31: 374–382.

    Article  CAS  Google Scholar 

  31. Gimelli A et al. Homogeneously reduced versus regionally impaired myocardial blood flow in hypertensive patients: two different patterns of myocardial perfusion associated with degree of hypertrophy. J Am Coll Cardiol 1998; 31: 366–373.

    Article  CAS  Google Scholar 

  32. Brush JE et al. Abnormal endothelium dependent coronary vasomotion in hypertensive patients. J Am Coll Cardiol 1992; 19: 809–815.

    Article  Google Scholar 

  33. Hoffman JIE . Maximal coronary flow and concept of coronary vascular reserve. Circulation 1984; 70: 153–159.

    Article  CAS  Google Scholar 

  34. Laughlin MH, McAllister RM . Exercise training-induced coronary vascular adaptation. J Appl Physiol 1992; 73: 2209–2225.

    Article  CAS  Google Scholar 

  35. Heiss HW et al. Studies on the regulation of myocardial blood flow in man. I: training effects on blood flow and metabolism of the healthy heart at rest and during standardized heavy exercise. Basic Res Cardiol 1976; 71: 658–675.

    Article  CAS  Google Scholar 

  36. Laughlin MH, Oltman CL, Bowles DK . Exercise training-induced adaptation in coronary circulation. Med Sci Sport Exerc 1998; 30: 352–360.

    Article  CAS  Google Scholar 

  37. Gielen S, Schuler G, Hambrect R . Exercise training in coronary artery disease and coronary vasomotion. Circulation 2001; 103: e1–e6.

    Article  CAS  Google Scholar 

  38. Tune JD et al. Role of nitric oxide and adenosine in control of coronary blood flow in exercising dogs. Circulation 2000; 101: 2942–2948.

    Article  CAS  Google Scholar 

  39. Johnson PC . The myogenic response. In: Handbook of Physiology: The Cardiovascular System, Vol. II: Vascular Smooth Muscle. American Physiology Society: Bethesda, MD, 1980, pp 409–442.

    Google Scholar 

  40. Laughlin MH . Endothelium-mediated control of coro- nary vascular tone after chronic exercise training. Med Sci Sports Exerc 1995; 27: 1135–1144.

    Article  CAS  Google Scholar 

  41. Kaul S . Myocardial contrast echocardiography: 15 years of research and development. Circulation 1997; 96: 719–724.

    CAS  PubMed  Google Scholar 

Download references

Acknowledgements

We thank Dr Antonella Freschi for her contribution to the editing of the paper and Dr Engineer Roberto Farina, Philips S.p.A, Italy and Dr Paolo Tacchi, EMAC, Pisa, Italy, for their precious technical support.

Author information

Authors and Affiliations

  1. Cardiac and Thoracic Department of University of Pisa, Pisa, Italy

    V Di Bello, D Giorgi, R Pedrinelli, E Talini, C Palagi, C Nardi, G Dell'Omo, M G Delle Donne & M Mariani

  2. Clinical Physiology Institute, CNR Pisa, Italy

    M Paterni

Authors
  1. V Di Bello
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. D Giorgi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. R Pedrinelli
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. E Talini
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. C Palagi
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. C Nardi
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. G Dell'Omo
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. M G Delle Donne
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. M Paterni
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. M Mariani
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to V Di Bello.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Di Bello, V., Giorgi, D., Pedrinelli, R. et al. Coronary microcirculation into different models of left ventricular hypertrophy—hypertensive and athlete's heart: a contrast echocardiographic study. J Hum Hypertens 17, 253–263 (2003). https://doi.org/10.1038/sj.jhh.1001547

Download citation

  • Received:

  • Revised:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.jhh.1001547

Keywords

Search

Advanced search

Quick links