Bischof T, Schneider J
Institut für Pathologie, Universität Zürich.
Schweiz Rundsch Med Prax. 1992 May 5;81(19):626-31.
The heart of the elderly is characterized by increased occurrence of characteristic calcifications on mitral and aortic valves. These valves have been found calcified in persons older than 70 years at about equal frequency, in nearly 50% of these individuals simultaneously. A calcified mitral ring was more common in females of all age classes, aortic calcifications showed a less marked difference for gender. Only the most severe calcifications of the mitral ring have hemodynamic consequences. The clinical significance of these calcifications lie in their propensity for bacterial colonisation. The risk for infective endocarditis rises tenfold. Aortic valves, calcified by degenerative processes, lead to more pronounced alterations of hemodynamics. In nearly one half of the patients this type of calcification results in stenosis with corresponding left ventricular hypertrophy. Since coronary arteriosclerosis has a similar age distribution the risk for ischemic heart disease is increased. Early and particularly frequent calcifications of the aortic valve develop in patients with bicuspid valves. Risk for infective endocarditis is also raised by a factor of ten in patients with calcified aortic valve.
老年人心脏的特点是二尖瓣和主动脉瓣出现特征性钙化的发生率增加。在70岁以上的人群中,这些瓣膜出现钙化的频率大致相同,近50%的个体同时出现钙化。钙化的二尖瓣环在所有年龄段的女性中更为常见,主动脉钙化在性别上的差异不那么明显。只有最严重的二尖瓣环钙化才会产生血流动力学后果。这些钙化的临床意义在于它们易于细菌定植。感染性心内膜炎的风险增加十倍。因退行性病变而钙化的主动脉瓣会导致更明显的血流动力学改变。在近一半的患者中,这种类型的钙化会导致狭窄并伴有相应的左心室肥厚。由于冠状动脉粥样硬化具有相似的年龄分布,缺血性心脏病的风险增加。二叶式主动脉瓣患者早期尤其是频繁出现主动脉瓣钙化。钙化主动脉瓣患者感染性心内膜炎的风险也会增加十倍。