Detection of Myocardial Ischemia in Hypertensive Patients with Left Ventricular Hypertrophy and Strain Using Myocardial Perfusion Imaging and Coronary Angiography

Abstract

Systemic hypertension is a well known risk factor for coronary artry disease; accelerating the atherosclerotic process and sudden death.

Because of the high prevalence of hypertension, LVH and coronary artery disease, a high priority must be given to evaluate the non-invasive methods used in diagnosis of CAD in hypertensive patients with LVH.

The investigations that rely on the electrocardiogram are difficult to interpret in hypertensive patients with left ventricular hypertrophy and strain complaining of chest pain, because of base line electrocardiographic abnormalities. So the aim of our study was to evaluate stress Tc 99m Sestamibi SPECT as a non invasive method for diagnosis of coronary artery disease in this group of patients.

The present study included twenty five hypertensive patients referred for assessment of their chest pain. There were 17 males and 8 females. Their age ranged between 32 and 60 years with mean value of 50.3 +/- 7 years. Sixteen patients(64%) were smokers. Four (16%) were diabetic, 7 (28%) were receiving medications for dyslipidemia and three patients(12%) gave a family history of ischemic heart disease.