@article{3111345,
    title = "Subendocardial viability ratio as an index of impaired coronary flow reserve in hypertensives without significant coronary artery stenoses",
    author = "Tsiachris, D. and Tsioufis, C. and Syrseloudis, D. and Roussos, D. and Tatsis, I. and Dimitriadis, K. and Toutouzas, K. and Tsiamis, E. and Stefanadis, C.",
    journal = "Journal of Human Hypertension",
    year = "2012",
    volume = "26",
    number = "1",
    pages = "64-70",
    issn = "0950-9240, 1476-5527",
    doi = "10.1038/jhh.2010.127",
    keywords = "adenosine, adult;  angiocardiography;  article;  cardiovascular parameters;  clinical article;  comparative study;  controlled study;  coronary artery;  coronary artery obstruction;  coronary flow reserve;  diastolic blood pressure;  drug dose escalation;  drug dose increase;  female;  heart muscle ischemia;  heart muscle oxygen consumption;  human;  hypertension;  male;  microcirculation;  pulse wave;  subendocardial viability ratio;  tissue Doppler imaging;  tonometer, Aged;  Blood Flow Velocity;  Coronary Angiography;  Coronary Circulation;  Coronary Stenosis;  Coronary Vessels;  Endocardium;  Female;  Fractional Flow Reserve, Myocardial;  Heart Rate;  Humans;  Hypertension;  Male;  Microcirculation;  Middle Aged;  Myocardial Ischemia",
    abstract = "Subendocardial viability ratio (SEVR), calculated through pulse wave analysis, is an index of myocardial oxygen supply and demand. Our aim was to evaluate the relationship between coronary flow reserve (CFR) and SEVR in 36 consecutive untreated hypertensives (aged 57.9 years, 12 males, all Caucasian) with indications of myocardial ischaemia and normal coronary arteries in coronary angiography. CFR was calculated by a 0.014-inch Doppler guidewire (Flowire, Volcano, San Diego, CA, USA) in response to bolus intracoronary administration of adenosine (30-60 g). SEVR was calculated by radial applanation tonometry, while diastolic function was evaluated by means of transmitral flow and tissue Doppler imaging. Hypertensive patients with low CFR (n=24) compared with those with normal CFR (n=12) exhibited significantly decreased SEVR by 24.5% (P=0.002). In hypertensives with low CFR, CFR was correlated with SEVR (r=0.651, P=0.001). After applying multivariate linear regression analysis, age, left ventricular mass index, Em/Am, 24-h diastolic blood pressure (BP) and SEVR turned out to be the only independent predictors of CFR (adjusted R 2=0.718). Estimation of SEVR by using applanation tonometry may provide a reliable tool for the assessment of coronary microcirculation in essential hypertensives with indications of myocardial ischaemia and normal coronary arteries. © 2012 Macmillan Publishers Limited. All rights reserved."
}