Olmesartan, but not amlodipine, improved endothelium-dependent coronary dilation in hypertensive patients independent of BP reduction. These beneficial effects on coronary vasomotion might be via an antioxidant property of ARBs.

Coronary endothelial function is impaired in hypertension; however, the severity of this impairment varies among patients. We aimed to identify the predictors of coronary endothelial dysfunction among clinical variables related to hypertension and atherosclerosis. Twenty-seven untreated, uncomplicated essential hypertensive patients and 10 age-matched healthy controls were studied prospectively. Myocardial blood flow

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We evaluated whether myocardial b-adrenergic receptor (b-AR) density, as determined by 11 C-CGP12177 PET, could predict improvement of cardiac function by b-blocker carvedilol treatment in patients with idiopathic dilated cardiomyopathy (IDC). Methods: Ten patients with IDC (left ventricular ejection fraction [LVEF] , 45%) were studied. Myocardial b-AR density was estimated using 11 C-CGP12177 PET before treatment with carvedilol. Changes of LVEF in response to dobutamine infusion (DLVEF-dobutamine) were also measured by echocardiography. Changes of LVEF (DLVEF-carvedilol) were evaluated after 20 mo of carvedilol treatment. Results: Baseline myocardial b-AR density significantly correlated with DLVEF-carvedilol (r 5 20.88, P , 0.001). In contrast, DLVEF-dobutamine did not correlate with DLVEF-carvedilol (P 5 0.65). Myocardial b-AR density was the significant multivariate independent predictor of DLVEF-carvedilol (b 5 20.88, P , 0.001) among univariate predictors, including functional class (r 5 0.76, P , 0.05), plasma norepinephrine (r 5 0.85, P , 0.01), LVEF (r 5 20.64, P , 0.05), and age as confounding factors. Furthermore, myocardial b-AR density was significantly correlated with plasma norepinephrine (r 5 20.79, P , 0.01) and LVEF (r 5 0.70, P , 0.05). Conclusion: Myocardial b-AR density is more tightly related to improvement of LVEFcarvedilol than is cardiac contractile reserve in patients with IDC. Patients with decreased myocardial b-AR have higher resting adrenergic drive, as reflected by plasma norepinephrine, and may receive greater benefit from being treated by antiadrenergic drugs.

MFR is influenced not only by coronary stenosis severity but also by coronary risk factors. In particular, the influence of risk factors should be considered in regions without severe coronary stenosis.