Objectives: Anginal symptoms are noticed in a large number of patients having normal coronary arteries. This accounts for the microvascular changes occurring in the myocardium. Cardiac microvasculature is affected very quickly in many generalized diseases like Hypertension, Diabetes Mellitus 2 type (DM) etc when noticeable changes in the morphofunctional parameters have not yet developed, and leads to development of anginal symptoms. In the present study we have attempted to study, if treatment with ACE inhibitors can revert these changes as quickly, as they develop.

Materials and methods: 32 patients (21 men, 11women, mean age 51.15 ± 10.16 years) with Arterial Hypertension were examined for Coronary Flow Reserve (CFR) with the modified transthoracic echocardiographic method published earlier, before and after 8 week treatment with pirindopril 8 mg/day. Standard echocardiographic parameters were also measured.

Results: CFR in these patients was found to be reduced to 1,89 ± 0,41. The morphofunctional characteristics and blood pressure before and after treatment are shown in the table. Before treatment it is noticeable that CFR has reduced significantly in spite of minimal changes in morphofunctional characters. At the same time, on treatment with pirindopril 8 mg/day for 2 months morphometric and functional parameters demonstrated only minimal tendency for improvement (p > 0,5), but CFR improved significantly to 2,10 ± 0,42 (p = 0,0001).

Conclusion: Coronary Flow Reserve improves early with initiation of treatment, just like it reduces with the onset of systemic diseases. These changes can be noticed before significant improvement in morphofunctional characteristics of left ventricle.