This review highlights that uraemic patients develop specific structural cardiac abnormalities, such as LVH and fibrosis, which increase their susceptibility to ischaemia independent of coronary lesions.
May warrant ischemia risk reassessment in CKD beyond CAD; leaves open whether reversing uraemic changes improves outcomes.
Cardiac death secondary to ischaemia, but not necessarily associated with coronary lesions, is the leading cause of death in uraemic patients. This article reviews recent findings that demonstrate abnormalities of cardiac structure which have a bearing on ischaemia tolerance. These abnormalities comprise the following: (1) left ventricular hypertrophy not fully explained by increased mean arterial pressure, (2) interstitial fibrosis and (3) abnormalities of myocardial microvasculature, i.e. capillary rarefaction and arteriolar-wall thickening.
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Amann et al. (1996) studied this question.
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