Mitral ring calcification in idiopathic hypertrophie subaortic stenosis

Abstract

Idiopathic hypertrophie subaortic stenosis was diagnosed in 68 patients. The diagnosis was confirmed in 24 patients with both cardiac catheterization and echocardiography, in 22 patients with catheterization alone and in 22 with echocardiography alone. Coexistent calcification of the mitral valve anulus was noted in nine patients (37 percent) studied with catheterization and echocardiography, In seven (32 percent) studied with catheterization alone and in seven (32 percent) studied with echocardiography alone. On echocardiography, mitral anular calcification was recognized as a dense thick linear echo behind the mitral valve that disappeared abruptly at the junction between the left ventricle and the left atrium. The patients with calcification of the mitral valve anulus were older (mean 64.5 years) than those without calcification (mean 47.6 years) (P <0.001). Of the patients who underwent cardiac catheterization, 12 of 18 older than 55 years demonstrated mitral anular calcification as opposed to 4 of 28 younger than 55 years (P <0.001). Of the patients studied with echpcardiography, 7 of 14 older than 55 years demonstrated calcification compared with 0 of 8 younger than 55 years. This prevalence of mitral anular calcification was greater (P <0.001) than that found in age-matched control subjects without idiopathic hypertrophie subaortic stenosis undergoing catheterization and echocardiography. Hemodynamic data, including left ventricular pressures and outflow gradients, clinical symptoms and the prevalence of coronary disease were similar in both groups. Calcification of the mitral valve anulus is a frequent finding in older patients with idiopathic hypertrophie subaortic stenosis. Its demonstration should raise the suspicion of associated idiopathic hypertrophie subaortic stenosis.