ORCID Profile
0000-0001-9485-0652
Current Organisations
NYU School of Medicine
,
New York University School of Medicine
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Publisher: Elsevier BV
Date: 10-2019
DOI: 10.1016/J.JACC.2019.08.1017
Abstract: Chronic kidney disease (CKD) is a major risk factor for coronary artery disease (CAD). As well as their high prevalence of traditional CAD risk factors, such as diabetes and hypertension, persons with CKD are also exposed to other nontraditional, uremia-related cardiovascular disease risk factors, including inflammation, oxidative stress, and abnormal calcium-phosphorus metabolism. CKD and end-stage kidney disease not only increase the risk of CAD, but they also modify its clinical presentation and cardinal symptoms. Management of CAD is complicated in CKD patients, due to their likelihood of comorbid conditions and potential for side effects during interventions. This summary of the Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference on CAD and CKD (including end-stage kidney disease and transplant recipients) seeks to improve understanding of the epidemiology, pathophysiology, diagnosis, and treatment of CAD in CKD and to identify knowledge gaps, areas of controversy, and priorities for research.
Publisher: Massachusetts Medical Society
Date: 09-06-2016
DOI: 10.1056/NEJMC1602668
Publisher: Elsevier BV
Date: 11-2018
Publisher: American Diabetes Association
Date: 14-08-2017
DOI: 10.2337/DCI17-0026
Publisher: Elsevier BV
Date: 10-2019
DOI: 10.1016/J.KINT.2019.06.025
Abstract: Chronic kidney disease (CKD) is a major risk factor for valvular heart disease (VHD). Mitral annular and aortic valve calcifications are highly prevalent in CKD patients and commonly lead to valvular stenosis and regurgitation, as well as complications including conduction system abnormalities and endocarditis. VHD, especially mitral regurgitation and aortic stenosis, is associated with significantly reduced survival among CKD patients. Knowledge related to VHD in the general population is not always applicable to CKD patients because the pathophysiology may be different, and CKD patients have a high prevalence of comorbid conditions and elevated risk for periprocedural complications and mortality. This Kidney Disease: Improving Global Outcomes (KDIGO) review of CKD and VHD seeks to improve understanding of the epidemiology, pathophysiology, diagnosis, and treatment of VHD in CKD by summarizing knowledge gaps, areas of controversy, and priorities for research.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 25-08-2015
Abstract: Coronary artery disease and left ventricular hypertrophy are prevalent in the chronic kidney disease ( CKD ) and renal transplant ( RT ) population. Advances in cardiovascular magnetic resonance ( CMR ) with blood oxygen level–dependent ( BOLD ) technique provides capability to assess myocardial oxygenation as a measure of ischemia. We hypothesized that the myocardial oxygenation response to stress would be impaired in CKD and RT patients. Fifty‐three subjects (23 subjects with CKD , 10 RT recipients, 10 hypertensive ( HT ) controls, and 10 normal controls without known coronary artery disease) underwent CMR scanning. All groups had cine and BOLD CMR at 3 T. The RT and HT groups also had late gadolinium CMR to assess infarction/replacement fibrosis. The CKD group underwent 2‐dimensional echocardiography strain to assess fibrosis. Myocardial oxygenation was measured at rest and under stress with adenosine (140 μg/kg per minute) using BOLD signal intensity. A total of 2898 myocardial segments (1200 segments in CKD patients, 552 segments in RT , 480 segments in HT , and 666 segments in normal controls) were compared using linear mixed modeling. Diabetes mellitus ( P =0.47) and hypertension ( P =0.57) were similar between CKD , RT , and HT groups. The mean BOLD signal intensity change was significantly lower in the CKD and RT groups compared to HT controls and normal controls (−0.89±10.63% in CKD versus 5.66±7.87% in RT versus 15.54±9.58% in HT controls versus 16.19±11.11% in normal controls, P .0001). BOLD signal intensity change was associated with estimated glomerular filtration rate (β=0.16, 95% CI =0.10 to 0.22, P .0001). Left ventricular mass index and left ventricular septal wall diameter were similar between the CKD predialysis, RT , and HT groups. None of the CKD patients had impaired global longitudinal strain and none of the RT group had late gadolinium hyperenhancement. Myocardial oxygenation response to stress is impaired in CKD patients and RT recipients without known coronary artery disease, and unlikely to be solely accounted for by the presence of diabetes mellitus, left ventricular hypertrophy, or myocardial scarring. The impaired myocardial oxygenation in CKD patients may be associated with declining renal function. Noncontrast BOLD CMR is a promising tool for detecting myocardial ischemia in the CKD population.
Location: United States of America
No related grants have been discovered for Sripal Bangalore.