Mitral annular calcification in untreated chronic renal failure.
Clinical, biochemical, radiological and echo-cardiographic (echo) evaluation was done prospectively in 50 patients of untreated end stage chronic renal failure (CRF). While clinically congestive cardiac failure (CCF) was diagnosed in 24%, low ejection fraction on echo was found in only 16%. Echo in these cases showed evidence of cardiac chamber dilatation in most (mean LVID (D) 54.1 +/- 6.51 and (S) 36.4 +/- 6.9 mm, but parameters of cardiac functions were normal in most. Mitral annular calcification (MAC) was detected on echo in 26%. On comparing patients with MAC (Group I) and those without MAC (Group II), the aetiological factor found more frequently in Group I was diabetes (61.5% vs 35.1%, P less than 0.05). Clinical features such as older age (mean age 54 years vs 45.5 years), severe hypertension, and grade IV and above murmur (15.2% vs none) were more common among group I patients. However, the difference was not statistically significant. Parameters of calcium metabolism were similar in the two groups. Conduction disturbances (30.7% vs 5.4%) were significantly more common in Group I (P = 0.05). The mitral regurgitation due to MAC was of no haemodynamic significance. Complications of MAC syndrome were rare.
Chhabra
S C
SC
Department of Medicine, Dayanand Medical College & Hospital, Civil Lines, Ludhiana.
Puri
S
S
Wander
G S
GS
Shahi
R G
RG
D000328:Adult; D002114:Calcinosis / Q000209:etiology*; D002118:Calcium / Q000378:metabolism; D012080:Chronic Kidney Disease-Mineral and Bone Disorder / Q000150:complications; D004452:Echocardiography; D004562:Electrocardiography; D006801:Humans; D006973:Hypertension / Q000150:complications; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000378:metabolism; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000175:diagnosis / Q000209:etiology*; D008946:Mitral Valve Stenosis / Q000175:diagnosis / Q000209:etiology*; D011446:Prospective Studies
D002118:Calcium