TY - JOUR T1 - Coronary microvascular dysfunction: a key step in the development of uraemic cardiomyopathy? JF - Heart JO - Heart SP - 1302 LP - 1309 DO - 10.1136/heartjnl-2019-315138 VL - 105 IS - 17 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 Y1 - 2019/09/01 UR - http://heart.bmj.com/content/105/17/1302.abstract N2 - 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. ER -