Garikapati Kartheek, Goh Daniel, Khanna Shaun, Echampati Krishna
Department of Internal Medicine, Toowoomba Hospital, Toowoomba, QLD, Australia.
University of New South Wales, Sydney, NSW, Australia.
Clin Med Insights Cardiol. 2021 Feb 23;15:1179546821998347. doi: 10.1177/1179546821998347. eCollection 2021.
Uraemic Cardiomyopathy (UC) is recognised as an intricate and multifactorial disease which portends a significant burden in patients with End-Stage Renal Disease (ESRD). The cardiovascular morbidity and mortality associated with UC is significant and can be associated with the development of arrythmias, cardiac failure and sudden cardiac death (SCD). The pathophysiology of UC involves a complex interplay of traditional implicative factors such as haemodynamic overload and circulating uraemic toxins as well as our evolving understanding of the Chronic Kidney Disease-Mineral Bone Disease pathway. There is an instrumental role for multi-modality imaging in the diagnostic process; including transthoracic echocardiography and cardiac magnetic resonance imaging in identifying the hallmarks of left ventricular hypertrophy and myocardial fibrosis that characterise UC. The appropriate utilisation of the aforementioned diagnostics in the ESRD population may help guide therapeutic approaches, such as pharmacotherapy including beta-blockers and aldosterone-antagonists as well as haemodialysis and renal transplantation. Despite this, there remains limitations in effective therapeutic interventions for UC and ongoing research on a cellular level is vital in establishing further therapies.
尿毒症心肌病（UC）被认为是一种复杂的多因素疾病，给终末期肾病（ESRD）患者带来了沉重负担。与UC相关的心血管发病率和死亡率很高，可能与心律失常、心力衰竭和心源性猝死（SCD）的发生有关。UC的病理生理学涉及传统相关因素（如血流动力学过载和循环尿毒症毒素）的复杂相互作用，以及我们对慢性肾脏病-矿物质骨病途径的不断深入理解。多模态成像在诊断过程中发挥着重要作用；包括经胸超声心动图和心脏磁共振成像，以识别表征UC的左心室肥厚和心肌纤维化的特征。在ESRD人群中合理使用上述诊断方法可能有助于指导治疗方法，如包括β受体阻滞剂和醛固酮拮抗剂在内的药物治疗以及血液透析和肾移植。尽管如此，UC的有效治疗干预仍存在局限性，在细胞水平上进行持续研究对于确立进一步的治疗方法至关重要。
