| Clinical and pathologic characteristics of dilated cardiomyopathy in hemodialysis patients. | |
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MedLine Citation:
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PMID: 15610259 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Some dialysis patients have impaired left ventricular (LV) function without coronary artery disease. The pathologic changes and prognoses of these patients have not been well described. METHODS: We performed LV endomyocardial biopsies on 40 hemodialysis patients with dilated cardiomyopathy (DCM; an ejection fraction <50% and a left ventricular end-diastolic volume index >90 mL/m(2) without coronary artery disease), and on 50 nondialysis patients with idiopathic DCM as the control group. Following LV biopsies, the patients were followed-up for a mean of 3.1 +/- 2.3 years. RESULTS: The pathologic characteristics of the dialysis group were severe myocyte hypertrophy (the mean myocyte diameter across the nucleus: 37.6 +/- 10.5 mum vs. 25.6 +/- 7.7 mum, P= 0.001), myocyte disarray (30%), and extensive fibrosis (the mean percent area of left ventricular fibrosis: 22.3 +/- 18.4% vs. 21.3 +/- 14.6%, P= NS). These pathologic characteristics resembled the dilated phase of hypertrophic cardiomyopathy. In the dialysis group, a high percent area of LV fibrosis was the only significant predictor of cardiac death by multivariate analysis (P= 0.02). The 3-year cumulative event-free survival rate for cardiac death in dialysis patients with severe fibrosis (more than 30%) was 42%, while that for patients without severe fibrosis was 82% (P= 0.03). CONCLUSION: The pathologic characteristics of the heart in dialysis patients with DCM are interstitial fibrosis and severe myocyte hypertrophy with occasional disarray. The extent of LV fibrosis is a strong predictor of cardiac death. Careful follow-up and treatment are necessary for dialysis patients with a high percent area of LV fibrosis. |
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Authors:
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Jiro Aoki; Yuji Ikari; Hiroyoshi Nakajima; Masaya Mori; Tokuichiro Sugimoto; Mitsuharu Hatori; Shuzou Tanimoto; Eisuke Amiya; Kazuhiro Hara |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Kidney international Volume: 67 ISSN: 0085-2538 ISO Abbreviation: Kidney Int. Publication Date: 2005 Jan |
Date Detail:
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Created Date: 2004-12-21 Completed Date: 2005-06-21 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0323470 Medline TA: Kidney Int Country: United States |
Other Details:
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Languages: eng Pagination: 333-40 Citation Subset: IM |
Affiliation:
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Division of Cardiology, Mitsui Memorial Hospital, Tokyo, Japan. aokijiro@aol.com |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Biopsy Cardiomyopathy, Dilated / etiology*, pathology*, ultrasonography Case-Control Studies Death, Sudden, Cardiac / etiology Female Fibrosis Hemodynamics Humans Male Middle Aged Renal Dialysis / adverse effects* Ventricular Dysfunction, Left / etiology, pathology, ultrasonography |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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