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Evaluation of the endothelial function in hypertensive patients with 13N-ammonia PET

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Journal of Nuclear Cardiology Aims and scope

Abstract

Background

Essential hypertension is one of the main risk factors for the development of coronary artery disease (CAD). Hypertension causes endothelial dysfunction which is considered an early sign for the development of CAD. Positron emission tomography is a non-invasive imaging technique that measures myocardial blood flow (MBF), allowing us to identify patients with endothelial dysfunction.

Methods and Results

19 patients without comorbidities recently diagnosed hypertensive, as well as 21 healthy volunteers were studied. A three-phase (rest, cold pressor test, and adenosine-induced hyperemia) 13N-ammonia PET was performed, and MBF was measured. Endothelial-Dependent Vasodilation Index, ΔMBF, and coronary flow reserve (CFR) were calculated for each patient. Hypertensive patients had a significantly higher systolic and diastolic blood pressures compared with the control group (134.6 ± 11.7/86.4 ± 10.6 mm Hg and 106.0 ± 11.8/71.4 ± 6.6 mm Hg, respectively, P < .001). The ENDEVI (1.28 ± 0.26 vs 1.79 ± 0.30, P < .001), the ΔMBF (0.81 ± 0.50 vs 0.25 ± 0.21, P < .001) and the CFR (2.18 ± 0.88 vs 3.17 ± 0.68, P = .001) were significantly lower in the hypertensive patients compared to the control group, 84% of the former group had endothelial dysfunction i.e., ENDEVI < 1.5 and 58% had vasomotor abnormalities, i.e., CFR < 2.5.

Conclusions

In this study, we showed that recently diagnosed hypertensive patients have coronary endothelial dysfunction and vasomotor disturbances which are early signs for the development of CAD.

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Acknowledgments

The authors would like to thank N. M. T. Jorge Albarrán and N. M. T. Andrés Sanabria for sharing their knowledge and expertise during the acquisition of the PET studies.

Conflict of interest

The authors would like to deny any conflict of interest. The authors of this article disclaim that they have no conflict of interest.

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Correspondence to Erick Alexánderson MD.

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Alexánderson, E., Jácome, R., Jiménez-Santos, M. et al. Evaluation of the endothelial function in hypertensive patients with 13N-ammonia PET. J. Nucl. Cardiol. 19, 979–986 (2012). https://doi.org/10.1007/s12350-012-9584-z

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  • DOI: https://doi.org/10.1007/s12350-012-9584-z

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