Twenty-five patients with stable arterial hypertension associated with the painful syndrome in the heart region were examined. In addition to the general clinical examination, all the patients were subjected to echocardiography, bicycle ergometry, and coronaroangiography. According to the character of alterations in the coronary arteries the patients were distributed into 3 groups. The first group comprised the patients with angiographically intact coronary arteries, the second the patients with initial atherosclerosis of the coronary arteries. The third group included the patients with disseminated atherosclerosis of the coronary arteries. In accordance with the bicycle ergometry data, the coronary insufficiency associated with essential hypertension was primarily related to the disseminated atherosclerosis of the coronary arteries. However, in cases of marked hypertrophy of the left ventricle the patients could develop relative coronary insufficiency. The pump and total contractile function of the myocardium remained satisfactory in all the examinees. In the third group patients, however, there were alterations in the local contractility as shown by the ventriculography findings. The diastolic function of the myocardium of the left ventricle was disordered in all the patients examined, while alterations in that function correlated with an increase in the mass of the left ventricle myocardium whatever the degree of changes in the coronary vessels.
Adult Aged