Mitral Annulus Calcification is associated with valvular and cardiac structural abnormalities

Mohammad-Reza Movahed,Yuji Saito,Mastaneh Ahmadi-Kashani,Ramin Ebrahimi

doi:10.1186/1476-7120-5-14

Abstract

IntroductionMitral annulus calcification (MAC) is a common finding on echocardiographic examination. The goal of this study was to evaluate associations between MAC and cardiac abnormalities using a large echocardiographic database.MethodsFor this study we retrospectively reviewed 24,380 echocardiograms performed for clinical reasons between the years 1984 and 1998.ResultsMAC was reported in 1,494 (6.1%) subjects. Using multivariate analysis, age, left ventricular hypertrophy (LVH), mitral regurgitation (MR), tricuspid regurgitation (TR), aortic stenosis (AS), left atrial (LA) enlargement and reversed E/A ratio were independently associated with MAC.)MAC was noted in 11.7 % of patients with MR vs. 4.3% without MR (OR: 2.0, CI 1.6–2.6, p < 0.0001), in 13.9% of those with TR vs. 4.5% without TR (OR: 3.8, CI 2.9–4.8, p < 0.0001), in 10.6% with LVH vs. 4.2% without LVH (OR: 1.9, CI 1.5–2.4, p < 0.0001), in 14.8% with AS vs. 5.5% without AS (OR: 1.4, CI 1.08–1.9, p = 0.01), in 9.4% with reversed E/A ratio vs. 3.8% without reversed E/A ratio (OR: 1.7, CI 1.4–2.2, p < 0.0001) and in 8.2% with LA enlargement vs. 4.8% without LA enlargement (OR: 1.3, CI 1.06–1.7, p = 0.02).ConclusionIn our study, MAC independently correlated with significant structural heart abnormalities. This suggests that identification of MAC may serve as a marker for other cardiac structural disorders.

Highlights

Mitral annulus calcification (MAC) is a common finding on echocardiographic examination
Multivariate analysis, we evaluated the association between age, gender, valvular abnormalities, pericardial effusion, decreased fractional shortening (FS defined as FS < 25%), left ventricular hypertrophy (LVH defined as left ventricular wall thickness >11 mm measured in standard parasternal long axis view involving at least one of the ventricular walls), aortic thickening, aortic root enlargement, abnormal early over late mitral flow reversal, body mass index (BMI>25) and enlarged left atrial (LA defined as left atrial size > 40 mm measured in standard parasternal long axis view), tricuspid regurgitation (TR), aortic regurgitation (AR) and aortic stenosis (AS)
MAC was significantly associated with age, gender, mitral regurgitation (MR), TR, AR AS, thickened aortic valve; abnormal early over late mitral flow reversal

Summary

Introduction

Mitral annulus calcification (MAC) is a common finding on echocardiographic examination. The goal of this study was to evaluate associations between MAC and cardiac abnormalities using a large echocardiographic database. Idiopathic (degenerative) mitral annular calcification (MAC) is one of the most common cardiac abnormalities found upon autopsy. The development of degenerative calcification of the mitral annulus is functionally of little consequence in most hearts, it shares common risk factors with atherosclerosis; including systemic hypertension, hypercholesterolemia, and diabetes [1]. Previous observational studies suggest that MAC might be associated with several other cardiovascular disorders such as atherosclerosis, MR, stroke, atrioventricular conduction defects and hypertrophic cardiomyopathy [4,5,6,7]. We performed comprehensive uni- and multivariate analyses to evaluate associations between MAC and cardiac abnormalities including valvular abnormalities, left ventricular hypertrophy (LVH) and left atrial (LA) enlargement

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