Structural causes of cardiac dysfunction in uremia.
While coronary heart disease is undoubtedly a major cause of cardiac morbidity and mortality in uremia, important noncoronary problems contribute to the common presence of cardiac problems. Based on clinical and experimental studies, we could show: (i) Left ventricular hypertrophy (LVH) can be dissociated, at least in part, from elevation of blood pressure. (ii) In uremia, PTH-dependent intermyocardiocytic fibrosis occurs; it may account, at least in part, for disturbed LV compliance and contribute to the arrhythmogenic potential. (iii) Blood pressure-independent abnormalities of intracardiac arterioles and reduced myocardial capillary supply are observed.
Department of Internal Medicine, University of Heidelberg, Germany.
M
M
Rambausek
K
K
Amann
G
G
Mall
E
E
Ritz
D000818:Animals; D003327:Coronary Disease / Q000150:complications*; D004719:Endomyocardial Fibrosis / Q000150:complications*; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000150:complications*; D008833:Microcirculation / Q000473:pathology; D009206:Myocardium / Q000473:pathology*; D051381:Rats; D014511:Uremia / Q000150:complications*