Prevalence and clinical outcomes of triglyceride deposit cardiomyovasculopathy among haemodialysis patients

Abstract

ObjectiveTo evaluate the effect of triglyceride deposit cardiomyovasculopathy (TGCV) on the cardiovascular outcomes in haemodialysis (HD) patients with suspected coronary artery disease (CAD).MethodsThis retrospective single-centre observational study included data from the cardiac catheter database of Narita Memorial Hospital between April 2011 and March 2017. Among 654 consecutive patients on HD, the data for 83 patients with suspected CAD who underwent both [123I]-β-methyl-iodophenyl-pentadecanoic acid scintigraphy and coronary angiography were analysed. Patients were divided into three groups: definite TGCV (17 patients), probable TGCV (22 patients) and non-TGCV control group (44 patients). The primary endpoint was a composite of cardiovascular death, non-fatal myocardial infarction and non-fatal stroke assessed for up to 5 years of follow-up.ResultsThe prevalence of definite TGCV was approximately 20% and 2.6% among consecutive HD patients with suspected CAD and among all HD patients, respectively. At the end of the median follow-up period of 4.7 years, the primary endpoint was achieved in 52.9% of the definite TGCV patients (HR, 7.45; 95% CI: 2.28 to 24.3; p<0.001) and 27.3% of the probable TGCV patients (HR, 3.28; 95% CI: 0.93 to 11.6; p=0.066), compared with that in 9.1% of the non-TGCV control patients. Definite TGCV was significantly and independently associated with cardiovascular mortality and outcomes among HD patients in all multivariate models.ConclusionsTGCV is not uncommon in HD patients and is associated with an increased risk of cardiovascular events including cardiovascular death. Thus, TGCV might be a potential therapeutic target.

Methods of calculating 123I-β-methyl-P-iodophenyl-pentadecanoic acid washout rates in triglyceride deposit cardiomyovasculopathy

“…Then, TGCV was encoded in the Orphanet (ORPHA code: 565612). Excessive TG accumulation in the myocardium and smooth muscle cells results in various complications including heart failure, cardiomyopathy, arrhythmia, coronary artery disease, chronic kidney disease, and skeletal muscle myopathy [12][13][14], all of which determine a poor prognosis. Early phase clinical trials with a novel orphan drug, CNT-01, have been successfully completed in Japan [15].…”

Rheocarna® as an alternative therapeutic option for patients with chronic limb-threatening ischemia: A case report

“…TGCV is a metabolic disease characterized by excessive triglyceride deposit accumulation in the heart or vessels and has a high target vessel revascularization rate and poor prognosis. 17 , 18 It has been reported that the factors relevant to coronary stent restenosis, including vascular endothelial growth factor-alpha, transforming growth factor-beta, and interleukin-6, exhibit distinct expression levels in mouse models of TGCV compared with those in the wild-type mice, which may influence the pathophysiology and treatment of CLTI, but the details are unknown. 19 Therefore, we considered that enforcing EVT against the occluded bypass graft would reocclude it; we used the Rheocarna first.…”

Genetic Deficiency of Adipose Triglyceride Lipase Is Associated With a Novel Type of Podocytopathy

“… 9 Recently, we reported a higher prevalence of TGCV in hemodialysis patients and the severe clinical outcomes of these patients, irrespective of the presence or absence of diabetes mellitus. 10 Patients with CKD have abnormal TG metabolism and suffer from cardiovascular diseases. Injuries of glomerular endothelial cells play a role in the early stages of CKD.…”