Myocardial dysfunction in end-stage renal disease
- Christopher deFilippi, MD, FACC
Christopher deFilippi, MD, FACC
- Vice Chair of Academic Affairs
- Inova Heart and Vascular Institute
- William L Henrich, MD, MACP
William L Henrich, MD, MACP
- Professor of Medicine
- President of the Health Science Center
- University of Texas Health Science Center School of Medicine
Cardiovascular disease, particularly myocardial dysfunction, is an important cause of morbidity and mortality in patients undergoing maintenance dialysis.
This topic reviews manifestations of myocardial dysfunction, including left ventricular hypertrophy (LVH), heart failure (HF), and arrhythmia in end-stage renal disease (ESRD) patients. Coronary heart disease in ESRD is discussed elsewhere. (See "Secondary prevention of cardiovascular disease in end-stage renal disease (dialysis)" and "Clinical manifestations and diagnosis of coronary heart disease in end-stage renal disease (dialysis)" and "Treatment of coronary heart disease in end-stage renal disease (dialysis)".)
Myocardial dysfunction in the general population is discussed elsewhere. (See "Management and prognosis of asymptomatic left ventricular systolic dysfunction" and "Clinical manifestations and diagnosis of asymptomatic left ventricular systolic dysfunction" and "Prognosis of heart failure" and "Ischemic cardiomyopathy: Treatment and prognosis".)
Cardiovascular disease accounts for over 40 percent of deaths in ESRD patients (figure 1) . In general, patients with even mild chronic kidney disease (CKD) have a greater burden of incident cardiovascular disease compared with similar age controls .
The specific causes of cardiovascular death are the same as in the general population and include ischemic causes, such as coronary heart disease, and nonischemic causes, such as cardiomyopathy, arrhythmias, and valvular heart disease.
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- LEFT VENTRICULAR HYPERTROPHY
- Risk factors
- Prevention and management
- HEART FAILURE
- Clinicopathologic features
- Risk factors
- - Natriuretic peptides
- Ventricular arrhythmias and sudden death
- Atrial fibrillation
- SUMMARY AND RECOMMENDATIONS