Coronary microvascular dysfunction: a key step in the development of uraemic cardiomyopathy?

Research output: Contribution to journalReview articlepeer-review

Authors

External organisations

  • Birmingham Cardio-Renal Group, Institute of Cardiovascular Sciences, University of Birmingham, Birmingham, UK.
  • Department of Cardiology, Queen Elizabeth Hospital, Birmingham
  • Department of Nephrology, University of Birmingham Research Laboratories, Queen Elizabeth Hospital Birmingham, Edgbaston, Birmingham, United Kingdom.
  • Green Lane Cardiovascular Service, Auckland City Hospital, Auckland, New Zealand.

Abstract

The syndrome of uraemic cardiomyopathy, characterised by left ventricular hypertrophy, diffuse fibrosis and systolic and diastolic dysfunction, is common in chronic kidney disease and is associated with an increased risk of cardiovascular morbidity and mortality. The pathophysiological mechanisms leading to uraemic cardiomyopathy are not fully understood. We suggest that coronary microvascular dysfunction may be a key mediator in the development of uraemic cardiomyopathy, a phenomenon that is prevalent in other myocardial diseases that share phenotypical similarities with uraemic cardiomyopathy such as hypertrophic cardiomyopathy and heart failure with preserved ejection fraction. Here, we review the current understanding of uraemic cardiomyopathy, highlight different methods of assessing coronary microvascular function and evaluate the current evidence for coronary microvascular dysfunction in chronic kidney disease.

Bibliographic note

© Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.

Details

Original languageEnglish
Pages (from-to)1302-1309
Number of pages8
JournalHeart
Volume105
Issue number17
Early online date25 Jun 2019
Publication statusPublished - Sep 2019

Keywords

  • myocardial disease