PMID- 16508657
OWN - NLM
STAT- MEDLINE
DCOM- 20061005
LR  - 20220316
IS  - 0085-2538 (Print)
IS  - 0085-2538 (Linking)
VI  - 69
IP  - 10
DP  - 2006 May
TI  - Redefinition of uremic cardiomyopathy by contrast-enhanced cardiac magnetic 
      resonance imaging.
PG  - 1839-45
AB  - Patients with end stage renal failure (ESRF) have an increased risk of premature 
      cardiovascular disease. Left ventricular (LV) abnormalities, so called 'uremic 
      cardiomyopathy', are associated with poorer outcome. Cardiac magnetic resonance 
      imaging (CMR) accurately defines LV dimensions and identifies underlying 
      myocardial pathology. We studied the relationship between LV function and 
      myocardial pathology in ESRF patients with CMR. A total of 134 patients with ESRF 
      underwent CMR. LV function was assessed with further images acquired after 
      gadolinium-diethylentriaminepentaacetic acid (DTPA). The presence of myocardial 
      fibrosis was indicated by late gadolinium enhancement (LGE). Two main myocardial 
      pathologies were identified. A total of 19 patients (14.2%) displayed 
      'subendocardial LGE' representing myocardial infarction, which was associated 
      with conventional cardiovascular risk factors including a history of ischemic 
      heart disease (IHD) (P < 0.001), hypercholesterolemia (P < 0.05), and diabetes (P 
      < 0.01). Patients with subendocardial LGE had greater LV mass (P < 0.05), LV 
      dilation (P < 0.01), and LV systolic dysfunction (P < 0.001) compared to patients 
      with no evidence of LGE. The second pattern, 'diffuse LGE', seen in 19 patients 
      (14.2%) appeared to represent regional areas of diffuse myocardial fibrosis. 
      Diffuse LGE was associated with greater LV mass compared to patients without LGE 
      (P < 0.01) but not systolic dysfunction. In total, 28.4% of all patients 
      exhibited evidence of myocardial fibrosis demonstrated by LGE. In contrast to 
      published literature describing three forms of uremic cardiomyopathy - left 
      ventricular hypertrophy (LVH), dilation, and systolic dysfunction, we have shown 
      that LVH is the predominant cardiomyopathy specific to uremia, while LV dilation 
      and systolic dysfunction are due to underlying (possibly silent) ischemic heart 
      disease.
FAU - Mark, P B
AU  - Mark PB
AD  - Division of Cardiovascular and Medical Sciences, Gardiner Institute, University 
      of Glasgow, UK. pm124p@clinmed.gla.ac.uk
FAU - Johnston, N
AU  - Johnston N
FAU - Groenning, B A
AU  - Groenning BA
FAU - Foster, J E
AU  - Foster JE
FAU - Blyth, K G
AU  - Blyth KG
FAU - Martin, T N
AU  - Martin TN
FAU - Steedman, T
AU  - Steedman T
FAU - Dargie, H J
AU  - Dargie HJ
FAU - Jardine, A G
AU  - Jardine AG
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Kidney Int
JT  - Kidney international
JID - 0323470
RN  - 0 (Contrast Media)
RN  - K2I13DR72L (Gadolinium DTPA)
SB  - IM
CIN - Kidney Int. 2006 May;69(10):1711-2. PMID: 16688189
CIN - Nat Clin Pract Cardiovasc Med. 2007 Jan;4(1):22-3. PMID: 17180145
MH  - Adult
MH  - Aged
MH  - Cardiomyopathies/*diagnosis/physiopathology
MH  - Cardiomyopathy, Dilated/diagnosis/physiopathology
MH  - Contrast Media/*administration & dosage
MH  - Coronary Angiography/methods
MH  - Female
MH  - Fibrosis/pathology
MH  - Gadolinium DTPA
MH  - Humans
MH  - Hypercholesterolemia/blood
MH  - Hypertrophy, Left Ventricular/diagnosis/physiopathology
MH  - *Image Enhancement
MH  - Kidney Failure, Chronic/*diagnosis/physiopathology
MH  - *Magnetic Resonance Imaging, Cine
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/*diagnosis/physiopathology
MH  - Prospective Studies
MH  - Renal Replacement Therapy/methods
MH  - Risk Factors
MH  - Systole/physiology
MH  - Ventricular Dysfunction, Left/diagnosis/etiology/physiopathology
EDAT- 2006/03/02 09:00
MHDA- 2006/10/06 09:00
CRDT- 2006/03/02 09:00
PHST- 2006/03/02 09:00 [pubmed]
PHST- 2006/10/06 09:00 [medline]
PHST- 2006/03/02 09:00 [entrez]
AID - S0085-2538(15)51341-0 [pii]
AID - 10.1038/sj.ki.5000249 [doi]
PST - ppublish
SO  - Kidney Int. 2006 May;69(10):1839-45. doi: 10.1038/sj.ki.5000249.