Dietz A, Longin F
Rofo. 1976 Jul;125(1):13-8. doi: 10.1055/s-0029-1230406.
There has, up to now, not been general acceptance in the German literature of a definite relationship between radiologically visible coronary calcification and coronary heart disease. Anglo-American authors in general agree with our coronographic findings, which show a significantly increased incidence of such coronary changes in stenosing coronary artery disease. In a random sample of patients over 40 years of age, coronary calcification was found radiographically in 25%. Two-thirds of these patients were more than 60 years, but one quarter of the 50 to 60 year age group, and 15% of the 40 to 5-year age group showed these findings. In one group of 150 patients with coronary calcification, 68.9% suffered from coronary heart disease, 7.9% were suspicious and 23.2% had no symptoms. Conversely, in 100 patients with coronary heart disease, coronary calcification was present in 42. Calcification in several vessels was confined almost entirely to patients with advanced coronary disease. Coronary angiography in patients with normal E.C.G.'s, both at rest and after exercise, usually showed some reduction in the lumen corresponding to the area of calcification. In these patients the prognostic significance of the calcification in terms of further development of atherosclerosis must be considered. The localisation of the calcification in these cases is of significance. The clinical features, histology, localisation and investigation of the calcification by radiography is discussed. In our view this has considerable significance in the screening of coronary heart disease.
迄今为止,德国文献中尚未普遍接受放射学上可见的冠状动脉钙化与冠心病之间存在明确关系的观点。英美作者总体上认同我们的冠状动脉造影结果,该结果显示在狭窄性冠状动脉疾病中,此类冠状动脉病变的发生率显著增加。在一个40岁以上患者的随机样本中,通过X线摄影发现25%的患者存在冠状动脉钙化。这些患者中有三分之二年龄超过60岁,但50至60岁年龄组中有四分之一,40至50岁年龄组中有15%有这些表现。在一组150例有冠状动脉钙化的患者中,68.9%患有冠心病,7.9%疑似患病,23.2%无症状。相反,在100例冠心病患者中,有42例存在冠状动脉钙化。多支血管钙化几乎完全局限于晚期冠心病患者。心电图正常的患者,无论静息时还是运动后,冠状动脉造影通常显示钙化区域对应的管腔有一定程度的狭窄。对于这些患者,必须考虑钙化在动脉粥样硬化进一步发展方面的预后意义。这些病例中钙化的部位具有重要意义。本文讨论了钙化的临床特征、组织学、部位以及通过X线摄影进行的检查。我们认为这在冠心病筛查中具有相当重要的意义。