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Metastatic pulmonary calcification occurs in a chronic form in patients with malignancy, chronic renal failure, and primary hyperparathyroidism. A rapidly progressive form is associated with renal transplant failure. This case report describes chronic progressive pulmonary calcification after successful transplant with no obvious underlying cause.

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Maximum and minimum volumes of the left atrium (LA) were calculated from the biplane angiocardiograms of 18 men and four women without significant heart disease. The mean LA maximum volume was 63 cc ± 16 cc; the mean LA minimum volume was 31 cc±10 cc, and their difference, LA cyclic volume change, was 33 cc±13 cc. Larger LA volumes were associated with greater cyclic volume changes. LA cyclic volume changes constituted 38% of LV stroke volume. No significant correlation between LA volumes and age, sex, surface area, heart rate, LV end-diastolic volume, LV stroke volume, or cardiac output was found. Volume data in normal subjects support the thesis that the LA serves mainly as a reservoir and conduit for blood destined for the left ventricle and that its contractile function is less important. The relation of LA volume change to LV stroke volume appears abnormal in chronic mitral regurgitation and constrictive pericarditis.

Quantitative angiocardiographic methods have been used to determine left ventricular volume and left ventricular mass (LVM) in 100 patients with isolated mitral valve disease. Thirty-six patients had mitral stenosis (MS), 29 had mitral regurgitation (MR), and 35 had combined stenosis and regurgitation (MS + MR). Data on volume and LVM from these patients are presented and are related to standard flow and intracardiac pressure determinations and compared with normal values. In patients with MS, the mean end-diastolic volume per square meter of body surface area (EDV/m2) was 72 ml/m2 and was increased to 148 ml/m2 in those with MR. EDV/m2 correlated closely with the severity of regurgitation and less well with LV end-diastolic pressure. The mean LV stroke volume was slightly smaller than normal in patients with MS (38 ml/m2) and was greatly increased in those with MR (88 ml/M2). The LV stroke volume correlated closely with the severity of regurgitation, r = 0.928. The ejection fraction (EF) was low in 37% of patients with MS and in 22% of those with MS + MR and MR alone. Left atrial volume was larger than normal in all patients and, although generally larger in those with regurgitation, did not correlate with its severity. In contrast, cyclic left atrial volume change was correlated with the severity of mitral regurgitation, r = 0.785. The data are presented with cumulative distribution curves suitable for reference standards.