STRUCTURAL CAUSES OF CARDIAC DYSFUNCTION IN UREMIA

While coronary heart disease is undoubtedly a major cause of cardiac m orbidity and mortality in uremia, important noncoronary problems contr ibute to the common presence of cardiac problems. Based on clinical an d experimental studies, we could show: (i) Left ventricular hypertroph y (LVH) can be dissociated, at least in part, from elevation of blood pressure. (ii) In uremia, PTH-dependent intermyocardiocytic fibrosis o ccurs; it may account, at least in part, for disturbed LV compliance a nd contribute to the arrhythmogenic potential. (iii) Blood pressure-in dependent abnormalities of intracardiac arterioles and reduced myocard ial capillary supply are observed.