Impaired Left Ventricular Function During Exercise in Hypertensive Patients with Normal Coronary Arteriograms: Effects of Nifedipine

Abstract

Arterial hypertension implicates three possibly independent pathologic changes in the heart which at the time can effect an impaired ventricular function. On one hand, the relationship between hypertension and macroangiopathy, like coronary artery disease (CAD), is well known and their clinical importance can be appreciated. However, the effects of microangiopathy as represented by medial hypertrophy on left ventricular function are less well defined. Reports of Scheler et al. [2] concerning ST segment depression during Holter monitoring and its diagnosis as silent ischemia raises the following questions: Is ST segment depression during exercise ECG a false-positive finding in hypertensives with normal coronary angiograms, or does it actually demonstrate an ischemic reaction with subsequently impaired left ventricular function? Furthermore, does nifedipine have any effect on the hemodynamic parameters and on ST segment depression?