[Coronary morphometry in essential arterial hypertension].

To evaluate the prevalence and pathophysiological significance of I and II order coronary arteries with a tortuous course we reviewed 1530 coronaroventriculographies. Tortuosity was identified by the finding of 4 bendings at least, with an angle less than 60 degrees, present both in systole and in diastole. Morphologic alteration was found in 64% of hypertensives and in 13% only of non hypertensive coronaropathic patients; the prevalence was 58% in valvular aortic stenosis (being 16% in the remaining valvulopathies) and 100% in hypertrophic cardiomyopathy. No normal subject showed coronary tortuosity. A retrospective analysis of patients' echocardiograms pointed out a significant association between tortuosity and concentric left ventricular hypertrophy, expressed by mass/volume ratios clearly above the normal values (1 +/- 0.2): 1.6 +/- 0.17 in hypertensives, 2.1 +/- 0.2 in aortic stenoses and 2.6 +/- 0.2 in hypertrophic cardiomyopathy. Among hypertensive subjects, we selected a group with essential systemic hypertension and no coronary stenoses nor dysmetabolic diseases: this group was divided into 2 subgroups on the basis of presence or absence of coronary tortuosity. A comparison of these subgroups for age, echocardiographic parameters (left ventricular mass index, mass, mass/volume ratio, end systolic stress) and hemodynamic data (end diastolic left ventricular pressure, gradient: mean aortic pressure--end diastolic left ventricular pressure) showed no significant difference between patients with or without tortuosity. Moreover those patients were evaluated by ergometric test, echo stress, cold pressor test and dipyridamole stress test: a significantly higher prevalence of myocardial ischemia was found in the subgroup with tortuous vessels (63% versus 11%, p < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)