HYPERTENSIVE BLOOD PRESSURE RESPONSE IN ABCDE STRESS ECHOCARDIOGRAPHY IN PATIENTS WITH CORONARY ARTERY DISEASE

Objective: To evaluate the incidence and predictors of hypertensive response to exercise (HRE) during stress echocardiography (SE) and the effect of HRE on the results of ABCDE-SE.Design and method: The blood pressure response (BP) was analyzed in 193 patients (age 62 ± 10 years, 111 men, 57,5%) with SE due to known or suspected coronary artery disease in the single-center study. BP response was considered as hypertensive for a systolic BP (SBP) >190 mmHg on the treadmill and 200 mmHg on a bicycle ergometer in women and >210 mmHg and 220 mmHg, respectively, in men or when SBP rises relative to the baseline in men >60 mmHg, in women >50 mmHg. The frequency of HRE, predictors of its occurrence, and the relationship with results of ABCDE-SE were investigated. Results: HRE occurred in 70 patients (36,3%) with higher prevalence of low exercise tolerance (p=0.013). Patients with HRE showed higher values of peak blood flow velocity in the coronary artery both at rest and under load (p=0.009, p=0.008), peak left ventricular (LV) contractile reserve and force (p=0.002 and p=0.006). Predictors of HRE development: LAD stenting history, thickness of the posterior wall of the LV, LAD blood flow velocity and normal LV force at rest (p=0.006, p=0.022, p=0.004 and p=0.003), positive step C (p=0.005). Conclusions: There is a relationship between HRE and the results of SE, in particular the effect of peak BP on contractile reserve.