Cor Vasa 2013, 55(3):e212-e216 | DOI: 10.1016/j.crvasa.2013.03.013

Could severity of mitral annular calcification predict other left sided structural or functional abnormalities?

Ahmed M. Abdel-Salam^*, Mohamed Abdel-Zaher Abdallah

Cardiology Department, Ain Shams Faculty of Medicine, Ain Shams University, Cairo, Egypt

Objective: The prognostic value of MAC severity is important not only because it shares common risk factors with vascular atherosclerotic changes but also through increasing the cardiovascular morbidity and mortality. This study was conducted in order to evaluate association between severity of MAC and left sided echocardiographic abnormalities mainly left sided valvular abnormalities as well as left atrial systolic and diastolic functional abnormalities.

Methods: We prospectively obtained 12-lead electrocardiograms and transthoracic echocardiograms (TTE) on patients scheduled for non-emergent echocardiographic assessment at tertiary care hospital. MAC was graded as mild, moderate and severe. LA linear dimensions, LA filling and emptying volumes and left atrium ejection fraction were done specifically in addition to commonly measured TTE parameters.

Results: From the 80 patients considered for the study, 47 patients had mild MAC, 29 patients had moderate MAC and 4 patients had severe MAC. Valvular affection through echo-doppler assessment that included mainly mitral stenosis, mitral incompetence, aortic sclerosis as well as aortic incompetence showed a highly significant statistical difference (p-values 0.00, 0.00, 0.00 and 0.00 respectively). There was a highly significant statistical difference between patients with different degrees of MAC and LA linear dimension (p-value 0.00), all LA filling and emptying volumes as well as LA ejection fractions with the exception of LA passive emptying volume and LA passive ejection fraction were insignificant.

Conclusions: There is a direct proportionate relationship between severity of MAC and associated left sided valvular affection, increase LA linear dimension as well as lower overall LA function.

Keywords: Echocardiography; LA diastolic function; LA systolic function; Mitral annular calcification; Valvular abnormalities

Received: October 20, 2012; Accepted: March 21, 2013; Published: June 1, 2013  Show citation