Mitral annular calcification predicts mortality and coronary artery disease in end stage renal disease
Mitral annular calcification predicts mortality and coronary artery disease in end stage renal disease
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DOI：
10.1016/j.atherosclerosis.2006.03.033
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发表时间：
2007-04-01
期刊：
影响因子：
5.3
通讯作者：
Brecker, Stephen J. D.
中科院分区：
文献类型：
--
作者：
Sharma, Rajan;Pellerin, Denis;Brecker, Stephen J. D.
背景：在一组肾移植患者中，我们试图确定二尖瓣环钙化(MAC)是否可以预测死亡率和心脏病。方法：前瞻性研究140例患者。所有患者均行超声心动图和冠状动脉造影。严重的冠状动脉疾病(CAD)被定义为至少一条冠状动脉的管腔狭窄率为70%。结果：在2.2+/-0.7年的随访期内，有21人死亡。患者年龄较大(P=0.001)，左心室收缩末期内径(P=0.005)、舒张末内径(P=0.04)、左心房内径(P=0.001)、左室短轴缩短率(P=0.003)、左心室重量指数(P=0.04)和二尖瓣E/EA比值(P=0.03)均高于非患者。血浆钙(p=0.002)、磷(p=0.004)、心肌肌钙蛋白T(p=0.03)、N-末端B型利钠肽(p=0.004)浓度在两组间差异无统计学意义，但性别、总胆固醇、血红蛋白和肌酐无明显差异。糖尿病(p=0.001.0 3)、透析(p=0.0 5)、有显著冠心病(p=t；0.0 5)、服用含钙磷酸盐结合剂(p=0.0 2)和维生素D3(p=0.0 4)的比例显著增加。显著冠心病(OR12，95%CI 3.25，p=0.00 1)是MAC的唯一独立相关因素。结论：MAC与ESRD的死亡率增加和显著CAD有关。与无MAC的患者相比，这些患者的LV腔大小增加，LV收缩功能变差，LV充盈压升高。(C)2006爱思唯尔爱尔兰有限公司。保留所有权利。
Background We sought to determine whether mitral annular calcification (MAC) predicts mortality and cardiac disease in a group of renal transplant candidates.Methods: Hundred and forty patients were prospectively studied. All had echocardiography and coronary angiography. Significant coronary artery disease (CAD) was defined as luminal stenosis > 70% by visual estimation in at least one coronary artery. Results: There were 21 deaths over a follow-up period of 2.2 +/- 0.7 years. MAC occurred in 56 patients (40%) and was associated with higher mortality (p = 0.04).Patients with MAC were older (p = < 0.001), had larger left ventricular (LV) end systolic (p = 0.005) and LV end diastolic (p = 0.04) diameter, larger left atrial diameter (p = 0.001), lower LV fractional shortening (p = 0.003), larger LV mass index (P = 0.04) and higher mitral E/Ea ratio (p = 0.03) compared to those without. Plasma calcium (p = 0.002), phosphate (p = 0.004), cardiac troponin T (p = 0.03), N-terminal Pro-B-type natriuretic peptide (p = 0.004) concentrations were higher in those with MAC but gender, total cholesterol, haemoglobin and creatinine were similar in the two groups. The proportion diabetic (p 0.03), on dialysis (p = 0.05), with significant CAD (p = < 0.001), taking calcium containing phosphate binders (p = 0.02) and Vitamin D3 (p 0.04) was significantly higher in those with MAC. Significant CAD (OR 12, 95% CI 3.25, p = 0.00 1) was the only independent associate of MAC.Conclusions: MAC is associated with increased mortality and significant CAD in ESRD. These patients have increased LV cavity size, poorer LV systolic function, higher LV filling pressures compared to patients without MAC. (c) 2006 Elsevier Ireland Ltd. All rights reserved.