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Mitral annular calcification and aortic valve calcification may help in predicting significant coronary artery
Esmeray Acartürk1, Abdi Bozkurt, Murat Cayli
1Department of Cardiology, Cukurova University, School of Medicine, 01330 Adana, Turkey. kanarya@mail.cu.edu.tr
Insights
Mitral annular calcification (MAC) and aortic valve calcification (AVC) detected by echocardiography can help predict coronary artery disease (CAD). Their presence indicates a higher likelihood of CAD, aiding in early diagnosis and intervention.
Area of Science:
- Cardiology
- Diagnostic Imaging
- Atherosclerosis Research
Background:
- Mitral annular calcification (MAC) and aortic valve calcification (AVC) are linked to atherosclerosis.
- Transthoracic echocardiography (TTE) is a common imaging technique.
Purpose of the Study:
- To evaluate if MAC and AVC detected by TTE can predict significant coronary artery disease (CAD).
- To compare the predictive value of MAC and AVC against traditional cardiovascular risk factors.
Main Methods:
- Investigated 123 patients with significant CAD and 93 without CAD, confirmed by coronary angiography.
- Assessed the presence of MAC and AVC using TTE.
Main Results:
- MAC and AVC demonstrated moderate sensitivity and specificity in identifying CAD.
- The positive predictive value of MAC and AVC exceeded that of several conventional risk factors like hypertension and hypercholesterolemia.
- Negative predictive values for MAC and AVC were superior to most risk factors, except diabetes mellitus.
Conclusions:
- The presence of MAC and AVC on TTE may aid in predicting significant CAD.
- MAC and AVC should be considered alongside conventional risk factors for CAD assessment.
- Absence of MAC and AVC is a strong indicator of no significant CAD, surpassing most traditional risk factors.
Abstract:
Mitral annular calcification (MAC) and aortic valve calcification (AVC) are manifestations of atherosclerosis. To determine whether mitral annular calcification and aortic valve calcification detected by transthoracic echocardiography (TTE) might help in predicting significant coronary artery disease (CAD), 123 patients with significant CAD and 93 patients without CAD detected by coronary angiography were investigated. MAC and AVC identified CAD with a sensitivity and specificity of 60.2%, 55.9% and 74.8%, 52.7%, respectively, and with a negative and a positive predictive values of 51.5%, 64.3% and 61.3% and 67.6%, respectively. The positive predictive value of MAC was greater than gender, hypertension, and hypercholesterolemia. AVC showed a positive predictive value greater than gender, hypertension, family history, and hypercholesterolemia. The negative predictive values of MAC and AVC for CAD were greater than those of all risk factors except diabetes mellitus. In conclusion, presence of MAC and AVC on TTE may help in predicting CAD and should be added to conventional risk factors. Absence of MVC and AVC is a stronger predictor for absence of CAD than all conventional risk factors, except diabetes mellitus. Patients with MAC and AVC should be taken into consideration for the presence of significant CAD and thereby for diagnostic and therapeutic interventions in order to improve the prognosis.