[Association between mitral annulus calcification and atherosclerosis]

Mitral annulus calcification (MAC) is best diagnosed by transthoracic echocardiography. MAC is associated with known atherosclerotic risk factors such as diabetes mellitus, hypertension and hypercholesterolemia. It is also known from the literature that patients with MAC have higher prevalence of left atrial and left ventricular enlargement, hypertrophic cardiomyopathy, atrial fibrillation, aortic valve calcification and stenosis, various cardiac conduction defects, bacterial endocarditis, cardiovascular events and stroke, though the etiological basis is unknown. Pathological studies from the 80's present a theory that MAC is a form of atherosclerosis. During the past few years we conducted a few clinical studies in order to test this theory and to examine the association between MAC and known atherosclerotic phenomena. We found higher prevalence of aortic atheroma in patients with MAC, especially complex atheroma, and we also found a continuous correlation between the MAC and atheroma thickness. We also noted that MAC patients have a higher prevalence of carotid artery stenosis, coronary artery stenosis, peripheral artery stenosis and higher levels of anti beta 2-Glycoprotein I antibodies in patients with MAC thickness equal or greater than 5 mm. These studies support the theory that MAC is a form of atherosclerosis and define a group of patients with higher prevalence of atherosclerotic disease in multiple blood vessels.