Hemodialysis-induced Myocardial Stunning with No Obstructive Coronary Artery Disease: Pathophysiological Significance of Coronary Microvascular Dysfunction

Intern Med. 2024 Jul 15;63(14):2023-2026. doi: 10.2169/internalmedicine.2388-23. Epub 2023 Dec 4.

Abstract

Hemodialysis (HD)-induced myocardial stunning, characterized by transient left ventricular systolic dysfunction during HD, has been reported to be common and associated with a poor prognosis. However, the pathophysiology is not fully understood. We herein report a case of HD-induced myocardial stunning without obstructive coronary artery disease complicated by coronary microvascular dysfunction (CMD), suggesting that CMD plays a crucial role in the pathophysiology of this disease.

Keywords: coronary flow reserve; coronary microvascular dysfunction; index of microvascular resistance; myocardial ischemia; myocardial stunning.

Publication types

  • Case Reports

MeSH terms

  • Coronary Artery Disease / etiology
  • Coronary Artery Disease / physiopathology
  • Coronary Circulation / physiology
  • Coronary Vessels / diagnostic imaging
  • Coronary Vessels / physiopathology
  • Humans
  • Kidney Failure, Chronic / complications
  • Kidney Failure, Chronic / physiopathology
  • Kidney Failure, Chronic / therapy
  • Male
  • Microcirculation / physiology
  • Myocardial Stunning* / etiology
  • Myocardial Stunning* / physiopathology
  • Renal Dialysis* / adverse effects