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首页> 外文期刊>Journal of Clinical Medicine Research >Coronary Artery Calcification Seen Through Chest Radiography
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Coronary Artery Calcification Seen Through Chest Radiography

机译：通过胸部X线检查可见冠状动脉钙化

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Patients with end-stage renal disease (ESRD) on dialysis have poor overall survival, and cardiovascular (CV) is the main cause of mortality among these patients. Coronary calcification is an independent predictor of mortality and CV events in dialysis patients and can be accessed by using a computerized tomography scanning. The high cost of this procedure, however, precludes routine implementation of this method for the purposes of risk stratification. Aortic arch calcification has been associated with CV mortality in the general population. Also, vascular calcification beyond the thoracic aorta has been shown to be associated with mortality in ESRD patients. We presented here a case of a young patient with ESRD in which the coronary calcification could be cleared seen through simple chest radiography. This is a 35-year-old man with a history of ESRD secondary to pyelonephritis, who was receiving conventional hemodialysis thrice a week for the last 5 years. He was submitted to chest radiography as part of routine annual cardiac screening. His blood pressure was within the target limits, although much higher in lower limbs, generating a high ankle brachial index of 1.3. He also had secondary hyperparathyroidism. His physical examination was unremarkable, except for the presence of non-functioning arteriovenous fistulas in both arms and a central venous catheter. The last routine blood test showed calcium 9.0 mg/dL, phosphate 5.7 mg/dL, potassium 4.7 mEq/L, creatinine 7.4 mg/dL, alkaline phosphatase 175 U/L, and parathyroid hormone 1,745 pg/mL. Surprisingly, the chest radiography revealed a calcified aortic valve and a calcified coronary artery. This patient had sudden cardiac death few months after this radiography had been taken. We present here a case of coronary calcification that can be seen through simple chest radiography. Such images are not usually seen, although the risk of vascular calcification is high in this population, and is closely related to CV risk. Chest radiographs, nearly universally available provide a method for assessing coronary artery calcification. Such a finding is intriguing and should alert nephrologists and cardiologists for the high risk of CV death in these patients.J Clin Med Res. 2015;7(9):724-725doi: http://dx.doi.org/10.14740/jocmr2121w
机译：透析终末期肾病（ESRD）的患者总体生存率较差，心血管（CV）是这些患者中死亡的主要原因。冠状动脉钙化是透析患者死亡率和CV事件的独立预测因子，可通过使用计算机断层扫描来访问。但是，此过程的高成本使出于风险分层的目的而无法常规执行此方法。在一般人群中，主动脉弓钙化与心血管死亡相关。而且，已证明胸主动脉外的血管钙化与ESRD患者的死亡率有关。我们在这里介绍了一名年轻的ESRD患者，通过简单的胸部X线检查可以清除冠状动脉钙化。这是一名35岁的男性，有继发于肾盂肾炎的ESRD病史，过去5年每周接受常规血液透析三次。作为常规年度心脏筛查的一部分，他接受了胸部X光检查。他的血压在目标范围内，尽管下肢的血压要高得多，从而使踝臂指数达到1.3。他还患有继发性甲状旁腺功能亢进症。除了两只手臂和中央静脉导管均存在无功能的动静脉瘘外，他的身体检查无异常。上次常规血液检查显示钙9.0 mg / dL，磷酸盐5.7 mg / dL，钾4.7 mEq / L，肌酐7.4 mg / dL，碱性磷酸酶175 U / L和甲状旁腺激素1,745 pg / mL。令人惊讶的是，胸部X光片显示主动脉瓣钙化和冠状动脉钙化。该患者在进行了X线摄影后的几个月就因心源性猝死。我们在这里介绍了一个可以通过简单的胸部X线检查看到的冠状动脉钙化病例。尽管该人群中血管钙化的风险很高，并且与CV风险密切相关，但通常看不到此类图像。几乎可以普遍获得的胸部X光片提供了一种评估冠状动脉钙化的方法。这样的发现很有趣，应该提醒肾病专家和心脏病专家这些患者发生心血管死亡的高风险。 2015; 7（9）：724-725doi：http://dx.doi.org/10.14740/jocmr2121w

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