PT  - JOURNAL ARTICLE
AU  - Ashwin Radhakrishnan
AU  - Luke C Pickup
AU  - Anna M Price
AU  - Jonathan P Law
AU  - Nicola C Edwards
AU  - Richard P Steeds
AU  - Charles J Ferro
AU  - Jonathan N Townend
TI  - Coronary microvascular dysfunction: a key step in the development of uraemic cardiomyopathy?
AID  - 10.1136/heartjnl-2019-315138
DP  - 2019 Sep 01
TA  - Heart
PG  - 1302--1309
VI  - 105
IP  - 17
4099  - http://heart.bmj.com/content/105/17/1302.short
4100  - http://heart.bmj.com/content/105/17/1302.full
SO  - Heart2019 Sep 01; 105
AB  - The syndrome of uraemic cardiomyopathy, characterised by left ventricular hypertrophy, diffuse fibrosis and systolic and diastolic dysfunction, is common in chronic kidney disease and is associated with an increased risk of cardiovascular morbidity and mortality. The pathophysiological mechanisms leading to uraemic cardiomyopathy are not fully understood. We suggest that coronary microvascular dysfunction may be a key mediator in the development of uraemic cardiomyopathy, a phenomenon that is prevalent in other myocardial diseases that share phenotypical similarities with uraemic cardiomyopathy such as hypertrophic cardiomyopathy and heart failure with preserved ejection fraction. Here, we review the current understanding of uraemic cardiomyopathy, highlight different methods of assessing coronary microvascular function and evaluate the current evidence for coronary microvascular dysfunction in chronic kidney disease.