Depace N L, Rohrer A H, Kotler M N, Brezin J H, Parry W R
Arch Intern Med. 1981 Nov;141(12):1663-5.
Calcification of the mitral annulus developed in a patient while undergoing dialysis. The rapid onset of events corresponded to the onset of end-stage renal failure and uncontrolled secondary hyperparathyroidism. Sequential echocardiograms verified the progression of calcification of the annulus as well as the valve. A new systolic and diastolic murmur and reduced valve orifice on two-dimensional echocardiography suggested acquired nonrheumatic mitral stenosis and insufficiency. We propose that metastatic calcium deposition rather than long-term hypertensive and degenerative effects was the predominant mechanism for massive calcification of the annulus and valve. It is suggested that M-mode echocardiography be used sequentially to follow both the occurrence and progression of calcification of the mitral annulus or valve in patients with chronic renal failure, secondary hyperparathyroidism, or both.
一名正在接受透析治疗的患者出现了二尖瓣环钙化。病情的迅速发展与终末期肾衰竭及未控制的继发性甲状旁腺功能亢进的发作相对应。连续的超声心动图证实了瓣环以及瓣膜钙化的进展。新出现的收缩期和舒张期杂音以及二维超声心动图显示的瓣膜口缩小提示获得性非风湿性二尖瓣狭窄和关闭不全。我们认为转移性钙沉积而非长期高血压和退行性影响是瓣环和瓣膜大量钙化的主要机制。建议对患有慢性肾衰竭、继发性甲状旁腺功能亢进或两者皆有的患者，采用M型超声心动图连续监测二尖瓣环或瓣膜钙化的发生和进展情况。
