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

Intern Med. 2023 Dec 4. doi: 10.2169/internalmedicine.2388-23. Online ahead of print.

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.