Association of mitral annular calcification with cardiovascular risk factors and cardiac structural disease in patients with mitral regurgitation

Abstract

Objective: Mitral annular calcification (MAC) is the degenerative calcification of the supportive ring of mitral valve. In previous studies, MAC has been shown to be associated with atherosclerosis, and be an independent predictor of cardiovascular disease. The purpose of this study was to evaluate the association of MAC with mitral regurgitation, cardiovascular risk factors and other cardiac structural disease. Material and Methods: We retrospectively reviewed 30 701 echocardiograms performed for various clinical indications between 2006-2007. Four thousand four hundred and forty six patients with mitral valve regurgitation were evaluated for MAC and its relation with severity of mitral regurgitation, cardiovascular risk factors and other cardiac structural and functional abnormalities. Results: MAC was diagnosed in 534 (12.0%) of the 4446 patients with mitral regurgitation. MAC was mostly observed in patients with older age, female gender, hypertension, diabetes mellitus, left atrial enlargement, atrial fibrillation, mitral stenosis and aortic stenosis. Presence of MAC was associated both with the severity of mitral regurgitation and mitral stenosis. In logistic regression analysis, older age, female gender, hypertension, left ventricular hypertrophy, diastolic dysfunction, left atrial enlargement, tricuspid regurgitation, aortic stenosis and mitral stenosis were independent predictors of with MAC. Among these variables, left ventricular hypertrophy was found to be the most predictive parameter of MAC. Conclusions: In this study, MAC independently associated with cardivascular risk factors and structural disease. Therefore, MAC may be used as a predictor of cardiovascular risk and cardiac structural abnormalities in daily clinical practice. Copyright © 2010 by Türkiye Klinikleri.