Assessment Of Soronary Flow Reserve In Hypertensive Patients By Dobutamine Transesophageal Doppler Echocardiograbhy

, Angina pectoris is a frequent symptom in patients withhypertensive LVHdespite normal epicardial coronary arteries.One of the supposed mechanisms of occurrence of chest painin those patients is the impairment of CFR. Coronary flowreserve is defined as the difference between maximal andbaseline coronary flow. 40 hypertensive subjects were selectedto enter our study and were subjected to the following:1. History and clinical examination.2. 12 lead ECG.3. Transthoracic echo, ardiooraphy.4. Coronary angiography.5. Transoesophageal echocardiography.Subjects were divided into 3 groups:Group (A): Normal healthy control subjects. (10)Group (B): Hypertensive non-LVH. (13)Group (C): Hypertensive LVH. (17)We recorded peak diastolic velocity (PDV) and peaksystolic velocity (PSV) on the bifurcation of main coronaryartery during rest, after intravenous infusion dobutamine.We calculated CFR as the ratio of PDV and PSV afterdobutamine. and PDV andPSV at resting baseline. We foundthat eFR was impaired in patients with hypertension eitherwith or without LVB in comparison with the control group.Also the impairment ofCFR was more in LVH group than nonLVII group.