Echographic-quantified severity of mitral anulus calcification: Prognostic correlation to related hemodynamic, valvular, rhythm, and conduction abnormalities

Abstract

Clinical and echocardiographic findings in 123 patients with mitral anulus calcification (MAC) were analyzed. In all patients M-mode echocardiography demonstrated a dense band of echoes posterior to the mitral valve, moving parallel and anterior to the left ventricular endocardium. Thirty-three per cent of patients were classified as having minimal to mild MAC (< 5 mm) and 67% had moderate to severe MAC (≥ 5 mm). There was a significant correlation between the degree of MAC to left atrial enlargement, congestive heart failure, aortic valve sclerosis, mitral regurgitation, atrial fibrillation, and AV-fascicular conduction defects. ECG evidence of conduction disturbances was significantly associated with MAC ≥ 5 mm in width. The echocardiographic demonstration of MAC ≥ 5 mm was significantly associated with the clinical implications known to occur with MAC; this echographic finding has important prognostic value in the evaluation of patients with mitral anulus calcification.