The state of theleft ventricle of the heart and 24-h profile of arterial pressure in patients with effort angina and episodes of painlessmyocardial ischemia

Aim. To study association between the state of the left ventricle (LV) of the heart, characteristics of a
24-h profile of arterial pressure (AP) and episodes of painless myocardial ischemia (PMI).
Material and methods. Echocardiography, bifurcation 24-h monitoring of AP and ECG were conducted in 137patients with effort angina (EA) receiving clinically effective antianginal therapy.
Results. Episodes of PMI at daytime were detected in 33 (24.1%) patients, at day and nighttime in 10
(7.3%) patients. There were significant differences neither by LV state nor by 24-h AP profile in patients free of PMI and those with daytime episodes. Patients with day and night PMI episodes had dilated LV and a decreased fall of night AP. Comparison of the parameters of 24-h AP and ECG monitoring has demonstrated that PMI episodes follow a rise in systolic and diastolic AP. In ischemia
systolic and diastolic AP rise. In postischemic period systolic AP lowered while diastolic AP rose higher.
Conclusion. Changes in diastolic AP may contribute to both onset and arrest of PMI. Decreased night
fall in AP is one of the mechanisms compensating impaired coronary circulation.

arterial hypertension, coronary heart disease, painless myocardial ischemia, 24-h monitoring of arterial pressure