Abstract :
Background: It has been reported that coronary flow reserve decreased in nearly all patients when left ventricular mass index (LVMI) become 50% its normal values. Aim of Study: Correlation between LVMI, exercise ECG and coronary angiography findings to determine timing of catheterization in ischemic hypertensive patients. Patients and Methods: Three hundred and eight seven patients had been divided into group I with no hypertension including 195 cases, and group II with hypertension and included 192. The latter group had been subdivided into hypertensive with no left ventricular hypertrophy (LVH) 83/192 group Ha, and hypertensive with LVH 109/192 group lib. This group lib has been subdivided again into group Ilbl with LVMI 20% 23 cases, group IIb2 with LVMI 20 50% 13 cases and group IIb3 with LVMI 50% and including 73 cases. All cases had been subjected to clinical assessment, non- invasive assessment (resting ECG, exercise ECG, and Echocardiogram) and invasive test (coronary angiography). Results: Group I revealed 135 cases (69.3%) while group II showed 126 (65.6%) with CAD. The highest prevalence of CAD was observed in group IIb3. Stress ECG could detect CAD in group I with sensitivity of 53.3% versus 69.8% in group II (p=0.05) and specificity of 90% versus 78.8% respec¬tively with p 0.05. Conclusions: The higher the LVMI, the higher incidence of myocardial ischemia in exercise ECG and so, the higher incidence of CAD.
