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Myocardial calcification and cardiac dysfunction in chronic renal failure
S G Rostand1, C Sanders, K A Kirk
1Department of Medicine, University of Alabama, Birmingham 35294.
The American Journal of Medicine
|November 1, 1988
Summary
Increased myocardial calcium content in dialysis patients is linked to reduced left ventricular ejection fraction (LVEF). Poor calcium and phosphorus control, along with parathyroid hormone, may contribute to this cardiac dysfunction.
Area of Science:
- Cardiology
- Nephrology
- Radiology
Background:
- Myocardial calcium content is clinically relevant in end-stage renal disease (ESRD) but difficult to detect during life.
- Assessing myocardial calcium's impact on cardiac function in ESRD patients is crucial.
Purpose of the Study:
- To evaluate the relationship between myocardial calcium content and left ventricular ejection fraction (LVEF) in uremic patients undergoing dialysis.
Main Methods:
- Energy subtraction radiography measured myocardial calcium in dialysis patients, controls, and cardiomyopathy patients.
- Two-dimensional echocardiography assessed LVEF and left ventricular end-diastolic dimension.
- Laboratory tests included parathyroid hormone, calcium-phosphorus product, and other markers.
Main Results:
- Dialysis patients exhibited higher myocardial calcium content than controls.
- Elevated myocardial calcium correlated with lower LVEF and larger left ventricular end-diastolic dimension.
- Myocardial calcium content was associated with calcium-phosphorus product, vascular calcification, and race.
Conclusions:
- Increased myocardial calcium in dialysis patients may stem from poor mineral control and parathyroid hormone hyperactivity.
- Elevated myocardial calcium content is significantly associated with impaired myocardial function in ESRD patients.