Division of Cardiovascular Diseases, Mayo Clinic Arizona, Scottsdale, AZ, USA.
Circ J. 2010 Nov;74(11):2403-9. doi: 10.1253/circj.cj-10-0107. Epub 2010 Sep 29.
In patients with primary hyperoxaluria (PH), oxalate overproduction can result in recurrent urolithiasis and nephrocalcinosis, which in some cases results in a progressive decline in renal function, oxalate retention, and systemic oxalosis involving bone, retina, arterial media, peripheral nerves, skin, and heart. Oxalosis involving the myocardium or conduction system can potentially lead to heart failure and fatal arrhythmias.
A retrospective review of our institution's database was conducted for all patients with a confirmed diagnosis of PH between 1/1948 and 1/2006 (n=103). Electrocardiogram (ECG) and echocardiography were used to identify cardiac abnormalities. Ninety-three patients fulfilled the inclusion criteria, 58% were male. Mean follow-up was 11.9 (median 8.8) years. In 38 patients who received an ECG or echocardiography, 31 were found to have any cardiac abnormalities. Cardiac findings correlated with decline in renal function.
Our data suggests that physicians caring for patients with PH should pay close attention to cardiac status, especially if renal function is impaired.
在原发性高草酸尿症(PH)患者中,草酸过度产生可导致反复尿路结石和肾钙质沉着症,在某些情况下会导致肾功能进行性下降、草酸潴留以及涉及骨骼、视网膜、动脉中层、周围神经、皮肤和心脏的全身性草酸过多症。涉及心肌或传导系统的草酸过多症可能导致心力衰竭和致命性心律失常。
对我们机构在 1948 年 1 月至 2006 年 1 月期间确诊的所有 PH 患者的数据库进行了回顾性分析(n=103)。心电图(ECG)和超声心动图用于识别心脏异常。93 名患者符合纳入标准,其中 58%为男性。平均随访时间为 11.9 年(中位数 8.8 年)。在接受 ECG 或超声心动图检查的 38 名患者中,有 31 名患者存在任何心脏异常。心脏发现与肾功能下降相关。
我们的数据表明,治疗 PH 患者的医生应密切关注心脏状况,尤其是在肾功能受损的情况下。