Key result
Mitral annular calcification linked to a ~138% higher rate of mitral regurgitation and increased stenosis.
Why the study?
Mitral annular calcification is increasingly observed in the elderly, but its incidence and association with mitral valvular disease required investigation.
Is mitral annular calcification associated with an increased prevalence of significant mitral valvular disease in patients undergoing echocardiography?
Observational (n=13,483)
Is mitral annular calcification associated with an increased prevalence of significant mitral valvular disease in patients undergoing echocardiography?
Absolute Event Rate: 11.9% vs 5%
p-value: p=<0.0001
Mitral annular calcification is a common echocardiographic finding (14% prevalence) that is significantly associated with higher rates of moderate-to-severe mitral stenosis and regurgitation.
MAC on echocardiography may warrant valvular assessment; leaves open progression risk and management implications in prospective studies.
BACKGROUND: Mitral annular calcification (MAC) is increasingly observed in elderly population. The purpose of this study was to investigate incidence of MAC and its association with mitral valvular disease (MVD). METHODS: A total of 13,483 consecutive patients who underwent echocardiography were enrolled. MAC was defined as an echo-dense, shelf-like structure with an irregular, lumpy appearance involving the mitral valve annulus, with acoustic shadowing. Prevalence of MAC and its association with significant mitral stenosis (MS) or mitral regurgitation (MR) were studied. Significant (≥moderate) MS was defined as mean transmitral valvular pressure gradient > 5 mm Hg and significant MR was defined as ≥moderate MR based on quantitative or semi-quantitative Doppler methods. RESULTS: MAC was present in 1881 of 13,483 patients (14%). Patients with MAC (MAC group) was older and more female gender than those without MAC (non-MAC group). Significant MS was present in 2.2% of MAC and in .6% of the non-MAC group (p < 0.0001). Significant MR was present in 11.9% of MAC and in 5.0% of the non-MAC group (p < 0.0001). Co-existence of MAC and aortic valve replacement (AVR) was associated with increased prevalence of MVD (MS:11.4%, MR:17.2%, respectively). CONCLUSION: MAC was present in 14% of the patients and was associated with significant MVD. Co-existence of MAC and AVR may increase the risk of MVD.
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Okura et al. (2021) conducted an observational in Mitral annular calcification and mitral valvular disease (n=13,483). Mitral annular calcification (MAC) vs. No MAC was evaluated on Significant mitral regurgitation (MR) (p=<0.0001). Mitral annular calcification was associated with higher rates of mitral regurgitation (11.9% vs 5.0%, p<0.0001) and mitral stenosis (2.2% vs 0.6%, p<0.0001) compared to patients without calcification.
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