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Cardiac disease in chronic uremia: pathophysiology
Advances in Renal Replacement Therapy
|July 1, 1997
Summary
Chronic uremia causes heart abnormalities including hypertrophy and fibrosis. Microvascular issues and metabolic changes in the heart reduce its tolerance to ischemia.
Area of Science:
- Cardiology
- Nephrology
- Pathology
Background:
- Chronic uremia is associated with cardiovascular complications.
- Cardiac abnormalities in uremia extend beyond coronary lesions.
Purpose of the Study:
- To detail cardiac abnormalities in chronic uremia.
- To explore the mechanisms behind reduced ischemic tolerance.
Main Methods:
- Review of recent findings on cardiac structure and function in chronic uremia.
- Analysis of myocardial metabolic and vascular changes.
Main Results:
- Left ventricular hypertrophy and interstitial myocardial fibrosis are prevalent.
- Reduced myocardial perfusion reserve is linked to arterial and capillary changes.
- Myocardial metabolism is impaired, affecting beta-adrenergic response, calcium handling, energy metabolism, and glucose uptake.
Conclusions:
- Chronic uremia induces complex cardiac abnormalities.
- Microvascular dysfunction and metabolic alterations significantly impair the heart's ischemic tolerance.