Kido Takashi, Tanimoto Kazuki, Watanabe Takuji, Taira Masaki, Narita Jun, Ishida Hidekazu, Ishii Ryo, Ueno Takayoshi, Miyagawa Shigeru
Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine, 2-2, Yamada-Oka, Suita, Osaka 565-0871, Japan.
Department of Pediatrics, Osaka University Graduate School of Medicine, 2-15, Yamada-Oka, Suita, Osaka 565-0871, Japan.
Eur Heart J Imaging Methods Pract. 2024 Jul 30;2(3):qyae079. doi: 10.1093/ehjimp/qyae079. eCollection 2024 Jul.
Myocardial calcification is an unusual condition in which excess calcium is deposited in the myocardium. Herein, we report two cases of myocardial calcification from our clinical experience. Furthermore, we conduct a systematic review to examine the clinical course and associated pathologies of myocardial calcification.
This systematic review was registered in PROSPERO (CRD42023463285). PubMed and Scopus were searched according to the following inclusion criteria: (i) case reports or case series describing patients with myocardial calcification; (ii) diagnosis of myocardial calcification by computed tomography (CT); (iii) adequate description of patients, including their chief complaint, medical history, evaluations, and treatments; and (iv) publication in English. Among the 75 patients, 24 had sepsis, 14 had myocarditis, and 37 had other pathologies. The mortality rate was 33% for patients with sepsis, 14% for patients with myocarditis, and 11% for patients with other pathologies. Follow-up CT findings beyond 2 years were reported in six patients, showing that the CT findings of myocardial calcification persisted but subsided over time. Autopsy was performed in seven patients, and extensive interstitial fibrosis and collection of inflammatory cells were observed in patients with myocarditis, sepsis, and ischaemic heart disease.
While various medical conditions can cause myocardial calcification, accompanying conditions commonly reported with myocardial calcification were sepsis and myocarditis. The CT findings of myocardial calcification tend to regress over time if the underlying disease can be treated.
心肌钙化是一种不常见的病症，其中过量的钙沉积在心肌中。在此，我们根据临床经验报告两例心肌钙化病例。此外，我们进行了一项系统评价，以研究心肌钙化的临床病程及相关病理情况。
本系统评价已在国际前瞻性系统评价注册库（PROSPERO，注册号：CRD42023463285）登记。根据以下纳入标准检索了PubMed和Scopus数据库：（i）描述心肌钙化患者的病例报告或病例系列；（ii）通过计算机断层扫描（CT）诊断心肌钙化；（iii）对患者进行充分描述，包括主诉、病史、评估和治疗；（iv）以英文发表。在75例患者中，24例患有脓毒症，14例患有心肌炎，37例患有其他病症。脓毒症患者的死亡率为33%，心肌炎患者为14%，其他病症患者为11%。6例患者报告了2年以上的随访CT结果，显示心肌钙化的CT表现持续存在但随时间消退。7例患者进行了尸检，在心肌炎、脓毒症和缺血性心脏病患者中观察到广泛的间质纤维化和炎性细胞聚集。
虽然多种病症可导致心肌钙化，但与心肌钙化常见伴随的病症是脓毒症和心肌炎。如果基础疾病能够得到治疗，心肌钙化的CT表现往往会随时间消退。
