Decreased coronary flow reserve in haemodialysis patients

Nephrol Dial Transplant. 2008 Jul;23(7):2324-8. doi: 10.1093/ndt/gfm954. Epub 2008 Jan 30.


Background: Coronary flow reserve (CFR) reflects the functional capacity of microcirculation to adapt to blood demand during increased cardiac work.

Methods: Forty-one patients who had already undergone coronary angiography were studied. They consisted of 21 haemodialysis patients with no significant left anterior descending coronary artery (LAD) stenosis and 20 non-renal failure patients without LAD stenosis. We performed transthoracic Doppler recording of diastolic coronary flow velocity in the LAD at baseline and after maximal vasodilatation by adenosine triphosphate (ATP) infusion. CFR was defined as the ratio of hyperaemic to basal averaged peak flow velocity.

Results: Although the peak coronary velocities during hyperaemia were similar between the two groups, CFR was smaller in haemodialysis (HD) patients than in control subjects (1.96 +/- 04 versus 2.3 +/- 0.5, P = 0.001) due to the higher baseline peak coronary velocities in the former.

Conclusions: The elevated baseline peak coronary velocity may be caused by cardiac hypertrophy and anaemia in HD patients.

MeSH terms

  • Aged
  • Anemia / physiopathology
  • Blood Flow Velocity / physiology
  • Case-Control Studies
  • Coronary Angiography
  • Coronary Circulation / physiology*
  • Coronary Vessels / physiopathology*
  • Female
  • Heart Ventricles / diagnostic imaging
  • Humans
  • Hypertrophy, Left Ventricular / diagnostic imaging
  • Hypertrophy, Left Ventricular / physiopathology
  • Kidney / blood supply
  • Kidney Failure, Chronic / physiopathology*
  • Kidney Failure, Chronic / therapy*
  • Male
  • Microcirculation / physiology
  • Middle Aged
  • Regional Blood Flow / physiology
  • Renal Dialysis*
  • Ultrasonography