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Effect of long-term cimetidine treatment on left ventricular function in haemodialysis patients with active
Insights
Long-term cimetidine improved cardiac function in chronic haemodialysis patients by suppressing hyperparathyroidism. This suggests a key role for uraemic hyperparathyroidism in developing uraemic cardiomyopathy.
Area of Science:
- Nephrology
- Cardiology
- Endocrinology
Background:
- Chronic kidney disease patients on haemodialysis often develop hyperparathyroidism.
- Hyperparathyroidism is linked to cardiovascular complications, termed uraemic cardiomyopathy.
Purpose of the Study:
- To investigate the effect of long-term oral cimetidine on left ventricular function in haemodialysis patients with hyperparathyroidism.
- To explore the potential role of hyperparathyroidism in uraemic cardiomyopathy.
Main Methods:
- Evaluated left ventricular function using radionuclide ventriculography and echocardiography.
- Assessed cardiac performance parameters like ejection fraction and mean velocity of circumferential fibre shortening.
- Monitored bone histology and biochemical markers including parathyroid hormone and serum calcium.
Main Results:
- Significant improvement in ejection fraction and mean velocity of circumferential fibre shortening observed after six months of cimetidine treatment.
- Improved cardiac performance correlated with enhanced bone histology.
- Minimal changes noted in C-terminal parathyroid hormone, serum calcium, and mean arterial pressure.
Conclusions:
- Cimetidine treatment positively impacts left ventricular function in haemodialysis patients with hyperparathyroidism.
- Suppression of uraemic hyperparathyroidism by cimetidine appears to be the mechanism for improved cardiac performance.
- Uraemic hyperparathyroidism is implicated as a significant contributor to uraemic cardiomyopathy.
Abstract:
1 The effect of long-term oral cimetidine on left ventricular function was evaluated in chronic haemodialysis patients with active hyperparathyroidism. 2 Radionuclide ventriculography (seven patients) and echocardiography (five patients) revealed a significant increase in ejection fraction and mean velocity of circumferential fibre shortening six months after treatment. 3 The improved cardiac performance was associated with improvement of bone histology. C-terminal parathyroid hormone, serum calcium, and mean arterial pressure changed little after treatment. 4 The improved cardiac performance is thought to be related to the suppression of uraemic hyperparathyroidism by cimetidine. 5 The present study suggests that uraemic hyperparathyroidism may play an important role in "uraemic cardiomyopathy".