Please wait a minute...
Reviews in Cardiovascular Medicine  2020, Vol. 21 Issue (2): 157-162     DOI: 10.31083/j.rcm.2020.02.99
Special Issue: Cardiovascular disorders in chronic kidney disease
Review Previous articles | Next articles
Accelerated and intensified calcific atherosclerosis and microvascular dysfunction in patients with chronic kidney disease
Meer Fakhry1, Mandeep S. Sidhu2, Sripal Bangalore3, Roy O. Mathew1, 4, *()
1Department of Medicine, University of South Carolina School of Medicine, Columbia, SC 29208, USA
2Department of Medicine, Division of Cardiology, Albany Medical College, Albany, NY 12208, USA
3Department of Medicine, Division of Cardiology, NYU Grossman School of Medicine, New York, NY 10016, USA
4Department of Medicine, Division of Nephrology, Columbia VA Health Care System, Columbia SC 29209, USA
Download:  PDF(629KB)  ( 623 ) Full text   ( 9 )
Export:  BibTeX | EndNote (RIS)      
Abstract:
Cardiovascular disease, and in particular coronary artery disease (CAD), remains an important contributor of morbidity and mortality among patients with chronic kidney disease (CKD). Classic symptomatology of CAD and effectiveness of established therapeutic measures is less frequent in patients with CKD. This suggests unique characteristics of CAD among patients with CKD. Two important features of CAD in CKD include increased calcific density of atherosclerotic plaques and of the vessels themselves (coronary artery calcification –– CAC), as well as a decrease in microcirculatory function –– or coronary microcirculatory dysfunction. A multitude of pathophysiologic pathways have been identified that contribute to CAC in CKD; less is known about the pathophysiology of microcirculatory dysfunction. It is not well established if these two processes are directly related to each other, but the combination results in a greater severity of effect on overall myocardial function and may in part explain the greater preponderance of silent myocardial infarction. Further investigation is needed to better understand these unique aspects of CAD in CKD as well as the role they play in overall CVD in this group, and ultimately therapeutics that may lessen the burden of disease.
Key words:  Chronic kidney disease      end stage renal disease      dialysis      coronary artery disease      coronary artery calcification      coronary microvascular dysfunction     
Submitted:  21 May 2020      Revised:  28 May 2020      Accepted:  02 June 2020      Published:  30 June 2020     
*Corresponding Author(s):  Roy O. Mathew     E-mail:  Roy.mathew@va.gov

Cite this article: 

Meer Fakhry, Mandeep S. Sidhu, Sripal Bangalore, Roy O. Mathew. Accelerated and intensified calcific atherosclerosis and microvascular dysfunction in patients with chronic kidney disease. Reviews in Cardiovascular Medicine, 2020, 21(2): 157-162.

URL: 

https://rcm.imrpress.com/EN/10.31083/j.rcm.2020.02.99     OR     https://rcm.imrpress.com/EN/Y2020/V21/I2/157

[1] Hai-Fu Zhang, Qin-Xia Zhang, Yuan-Yuan Zhang, Dong Yang, Zhao Xu, Qi-Bin Jiao, Xing-Wei Zhang. Efficacy and safety of left atrial appendage occlusion in atrial fibrillation patients with chronic kidney disease: a systematic review and meta-analysis[J]. Reviews in Cardiovascular Medicine, 2020, 21(3): 443-451.
[2] Anthony (Ming-yu) Chuang, Mau T Nguyen, Woon-Man Kung, Sam Lehman, Derek P Chew. High-sensitivity troponin in chronic kidney disease: Considerations in myocardial infarction and beyond[J]. Reviews in Cardiovascular Medicine, 2020, 21(2): 191-203.
[3] Zhanru Qi, Hongyan Zheng, Zhonghai Wei, Qing Dai, Jun Xie, Lian Wang, Jingmei Zhang, Jie Song. Short-term and long-term outcomes of bailout versus planned coronary rotational atherectomy[J]. Reviews in Cardiovascular Medicine, 2020, 21(2): 309-314.
[4] Megan S. Joseph, Maryse Palardy, Nicole M. Bhave. Management of heart failure in patients with end-stage kidney disease on maintenance dialysis: a practical guide[J]. Reviews in Cardiovascular Medicine, 2020, 21(1): 31-39.
[5] Yuhong Liu, Zhihuan Zeng, Xing Yu, Tudi Li, Yusi Yao, Rong Chen, Jianyi Zheng. Impact of lipoprotein(a) on long-term outcomes after percutaneous coronary intervention in patients with reduced low-density lipoprotein cholesterol[J]. Reviews in Cardiovascular Medicine, 2020, 21(1): 147-153.
[6] Michele Provenzano, Giuseppe Coppolino, Teresa Faga, Carlo Garofalo, Raffaele Serra, Michele Andreucci. Epidemiology of cardiovascular risk in chronic kidney disease patients: the real silent killer[J]. Reviews in Cardiovascular Medicine, 2019, 20(4): 209-220.
[7] Davide Bolignano, Anna Pisano, Graziella D’Arrigo. Pulmonary hypertension: a neglected risk condition in renal patients?[J]. Reviews in Cardiovascular Medicine, 2018, 19(4): 117-121.
[8] Sivakumar Sudhakaran, Teodoro Bottiglieri, Kristen M. Tecson, Aaron Y. Kluger, Peter A. McCullough. Alteration of lipid metabolism in chronic kidney disease, the role of novel antihyperlipidemic agents, and future directions[J]. Reviews in Cardiovascular Medicine, 2018, 19(3): 77-88.
[9] Peter A. McCullough, Aaron Y. Kluger, Kristen M. Tecson, Clay M. Barbin, Andy Y. Lee, Edgar V. Lerma, Zachary P. Rosol, Sivan L. Kluger, Janani Rangaswami. Inhibition of the Sodium–Proton Antiporter (Exchanger) is a Plausible Mechanism of Potential Benefit and Harm for Drugs Designed to Block Sodium Glucose Co-transporter 2[J]. Reviews in Cardiovascular Medicine, 2018, 19(2): 51-63.
[10] Christian O. Koelbl, Zoran S. Nedeljkovic, Alice K. Jacobs. Coronary Chronic Total Occlusion (CTO): A Review[J]. Reviews in Cardiovascular Medicine, 2018, 19(1): 33-39.
[11] Akanksha Agrawal, Deepanshu Jain, Eyob L. Feyssa, Aman M. Amanullah. Utility of Dobutamine Stress Echocardiography in Cardiac Risk Stratification of Patients Undergoing Orthotopic Liver Transplantation[J]. Reviews in Cardiovascular Medicine, 2017, 18(4): 146-154.
[12] Claudio Ronco, Federico Ronco, Peter A. McCullough. A Call to Action to Develop Integrated Curricula in Cardiorenal Medicine[J]. Reviews in Cardiovascular Medicine, 2017, 18(3): 93-99.
[13] Mehul A. Pragani, Karan P. Desai, Doralisa Morrone, Mandeep S. Sidhu, William E. Boden. The Role of Nitrates in the Management of Stable Ischemic Heart Disease: A Review of the Current Evidence and Guidelines[J]. Reviews in Cardiovascular Medicine, 2017, 18(1): 14-20.
[14] Sandeep K. Krishnan, Norman E. Lepor. Acute and Chronic Cardiovascular Effects of Hyperkalemia: New Insights Into Prevention and Clinical Management[J]. Reviews in Cardiovascular Medicine, 2016, 17(S1): 9-21.
[15] Raghunandan Muppidi, Laura Spranklin, William Scialla, Nauman Islam, Ronald Freudenberger, Robert Malacoff. Cardiotoxicity of Anticancer Therapies[J]. Reviews in Cardiovascular Medicine, 2015, 16(4): 225-234.
No Suggested Reading articles found!