Nephrol Dial Transplant (2000) 15: 1493-1503
© 2000 European Renal Association-European Dialysis and Transplant Association
Tony Raine Memorial Lecture
Microvascular disease—the Cinderella of uraemic heart disease
On October 14, 1995, Professor A. Raine (St Bartholomew's Hospital, London) died at the young age of 46 years. He was a fascinating man who combined a rigorous scientific approach with clinical acumen. He excelled in the fields of hypertension research and nephrological research. He was an inspiring investigator whose untimely death is mourned by many colleagues in European nephrology. NDT commemorates the outstanding contributions of our former subject editor in the field of hypertension by a contribution bearing on the major research topic of the late Professor Raine, i.e. the interrelation of kidney and blood pressure. Professor Antony Raine 21.7.49–14.10.95.
1 Department of Pathology, University of Erlangen-Nürnberg and 2 Department of Internal Medicine, University of Heidelberg, Germany
Abstract
It has been known for a long time that atherosclerosis, particularly plaques in the epicardiac coronary conduit arteries, are more frequent in patients with chronic renal failure than in non-uraemic patients. It has been only recently, however, that modification of post-stenotic remodelling of cardiac arteries as well as abnormalities of the arterioles and the capillaries in the myocardium of uraemic animals and uraemic patients have been recognized and analysed. These lesions can be dissociated from changes in blood pressure and may be an important cause contributing to reduced ischaemia tolerance and cardiac malfunction (pump failure, arrhythmia) thus predisposing to cardiac death. Recent insights into angiogenesis, particularly adaptive angiogenesis in response to hypoxia, may potentially provide novel approaches to the understanding and management of cardiac microangiopathy in renal failure.
Keywords: uraemia; uraemic cardiomyopathy; coronary heart disease; heart capillaries; myocardial infarction
Notes
Correspondence and offprint requests to: K. Amann, Department of Pathology, Krankenhausstrasse 8–10, D-91054 Erlangen, Germany.
After the first Tony Raine memorial lecture on the occassion of the Annual Meeting of the European Renal Association (ERA/EDTA) Madrid, Spain 5–8 September 1999.
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