Journal Article

Microvascular disease—the Cinderella of uraemic heart disease

Kerstin Amann and Eberhard Ritz

in Nephrology Dialysis Transplantation

Published on behalf of European Renal Association - European Dialysis and Transplant Assoc

Volume 15, issue 10, pages 1493-1503
Published in print October 2000 | ISSN: 0931-0509
Published online October 2000 | e-ISSN: 1460-2385 | DOI: http://dx.doi.org/10.1093/ndt/15.10.1493
Microvascular disease—the Cinderella of uraemic heart disease

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It has been known for a long time that atherosclerosis, particularly plaques in the epicardiac coronary conduit arteries, are more frequent in patients with chronic renal failure than in non‐uraemic patients. It has been only recently, however, that modification of post‐stenotic remodelling of cardiac arteries as well as abnormalities of the arterioles and the capillaries in the myocardium of uraemic animals and uraemic patients have been recognized and analysed. These lesions can be dissociated from changes in blood pressure and may be an important cause contributing to reduced ischaemia tolerance and cardiac malfunction (pump failure, arrhythmia) thus predisposing to cardiac death. Recent insights into angiogenesis, particularly adaptive angiogenesis in response to hypoxia, may potentially provide novel approaches to the understanding and management of cardiac microangiopathy in renal failure.

Keywords: uraemia; uraemic cardiomyopathy; coronary heart disease; heart capillaries; myocardial infarction

Journal Article.  5437 words.  Illustrated.

Subjects: Nephrology

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