Long-term follow-up of patients with echocardiographically detected mitral anular calcium and comparison with age- and sex-matched control subjects

Abstract

One hundred seven patients with echocardiographically documented mitral anular calcium (MAC) and 107 age- and sex-matched control subjects without MAC were studied and followed for a mean of 4.4 ± 2.4 (standard deviation) years. Fourteen (7%) patients were lost to follow-up. Compared with the control group, patients with MAC had higher frequency of precordial murmurs (p < 0.0001), cardiomegaly (p < 0.0001), left atrial enlargement (p < 0.0001), left ventricular enlargement (p < 0.0001), and rhythm and conduction disturbances (p < 0.0001). During the follow-up, patients with MAC had higher incidence of valve replacement (p < 0.0025), permanent pacemaker implantation (p < 0.0025), congestive heart failure (p < 0.0001), thromboembolic cerebrovascular event (p < 0.01), sudden death (p < 0.001) and total cardiac death (p < 0.0001). However, the frequencies of myocardial infarction, coronary artery bypass surgery and angioplasty, endocarditis or noncardiac death were not significantly different between patients with MAC and the control subjects. Thus, patients with MAC have higher frequencies of precordial murmurs, cardiomegaly, left atrial and ventricular enlargement, rhythm and conduction disturbances. They more frequently undergo valve replacement and permanent pacemaker implantation, develop congestive heart failure and die of cardiac causes than age- and sex-matched control subjects.