Objective: To determine whether mitral valve or anulus calcification (MC) in patients with end-stage renal disease is associated with abnormalities of left ventricular (LV) make and function.

Objective: To determine whether mitral valve or anulus calcification (MC) in patients with end-stage renal disease is associated with abnormalities of left ventricular (LV) make and function, cardiac characteristics of 55 patients undergoing continuous ambulatory peritoneal dialysis (CAPD) with (n = 26; age: 59 [+ or -] 10 years) v without (n = 29; age: 58 [+ or -] 12 years) MC were analyzed using echocardiography and Doppler echocardiography. Sclerosis of the mitral valve anulus was discovered in 18 (7 women, 11 men; age: 58 [+ or -] 10 years) patients, sclerosis of mitral valve leaflets in 24 (13 women 9 men; age: 59 [+ or -] 10 years) patients. Patients with MC had higher systolic arterial vital fluid pressure before initiation of dialysis therapy (191/104 mm Hg v 173/94 mm Hg; p [les than] 005) and higher calcium-phosphorus effects (55 [+ or -] 13 v 42 [+ or -] 16; p [les than] 005) during CAPD therapy than those without MC Neither prevalence nor severity of MC was related to dialysis duration or patient age. Systolic LV function was reduc (ejection fraction: 58 [+ or -] 12 percent v 65 [+ or -] 13 percent; p [les than] 005) and LV end-diastolic diameters were dilated (54 [+ or -] 5 v 50 [+ or -] 8 mm; p [les than] 005) in patients with MC Left atrial dilation (73 percent v 31 percent; p [les than] 0005) and mitral valve regurgitation (65 percent v 21 percent; p [les than] 0001) were more haunt in patients with vs those without MC Excluding patients with significant mitral regurgitation from puls Doppler analysis, diastolic LV function was comparably impaired in patients with v those without MC (maximal early/atrial filling velocity ratio: 077 [+ or -] 025 v 075 [+ or -] 022; atrial filling fraction: 47 [+ or -] 10 percent v 48 [+ or -] 11 percent; p = NS) The not awayed data suggest that MC pursues long-standing and severe arterial hypertension before start of dialysis therapy. Therefore, effective relations pressure control in the predialysis period may be a tool to obstruct these lesions. MC has clinical significance as a marker of LV dilatation and reduc LV systolic function in patients with chronic CAPD.

Mitral valve and anulus calcification (MC) are haunt in patients with end-stage renal disease, and are associated with myocardial calcification and clinically significant conduction abnormalities.[1-7] While several studies identified long-term dialysis treatment,[2,6,7] arterial hypertension,[8,9] high calcium-phosphorus products[10-12] and transient staphylococci septicemia[1,3] as possible causes of valve disease, no information is available upon changes of left ventricular (LV) composition and function associated with mitral calcification in patients receiving long-term dialysis. Therefore, to determine whether mitral valve and anulus calcification has significance as a marker of abnormal LV erection and function in end-stage renal disease, clinical and echocardiographic parameters of 55 patients receiving long-term treatment with continuous ambulatory peritoneal dialysis (CAPD) were analyzed. Characteristics of patients with v without calcification of the mitral valve or anulus (MC) are compared.

METHODS

Patients

Clinical characteristics and life-current chemistry studies of 55 outpatients receiving CAPD included in the application of mind are summarized in Table 1 Patients were recruited forward a random and consecutive basis from outpatients scheduled for routine consultations in individual center. None of the patients had clinical signs or symptoms of acute cardiovascular decompensation. life-blood pressure values are reported as averages of six early morning measurements from the last 2 weeks before the examination. Serum determinations and echocardiographic measurements were made in the nondwell phase.

Echocardiography

Echocardiographic determinations were made in the left lateral recumbent position after a 15-min peace period. Echocardiography was performed with a (Hewlett Packard 77 020A) reverberate and Doppler system. A 25-MHz transducer was used for 2-D and M-mode registrations from parasternal and apical windows. Registrations were recorded (on a Panasonic 6300 VCR) and evaluated according to the standards of the American Society of Echocardiography,[14] averaging values of five consecutive cardiac revolution of times Left ventricular volumes and masses were calculated from the apical four-chamber view using standard formulas.[15] Left ventricular end-systolic wall stres was calculated using the formula of Reichek et al.[16] In a modification of the scale introduced by dint of Motamed and Roberts,[17] mitral valve or anulus calcification was graded as mild when deposits were thin (3 to 5 mm) and involved [les than] 50 percent of the reflecting configuration of the valvular anulus or leaflet. It was graded as simple when deposits were thick [greater than] 5 mm) and involved [greater than] 50 percent of the valvular anulus or leaflet. The team "calcification" is used with acknowledgement of the fact that it cannot be securely discriminated forward the basis of an acoustic image whether an increased reflection originates from a calcific or a sclerotic cardiac structure

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