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Mitral annular calcification predicts mortality and coronary artery disease in end stage renal disease

Rajan Sharma1, Denis Pellerin, David C Gaze

  • 1Department of Cardiology, St George's Hospital, London, United Kingdom. rajdoc.Sharma@tiscali.co.uk

Atherosclerosis
|May 2, 2006
PubMed

Insights

Mitral annular calcification (MAC) predicts mortality and cardiac disease in renal transplant candidates. Patients with MAC showed higher mortality, increased left ventricular size, and poorer systolic function.

Area of Science:

  • Nephrology
  • Cardiology
  • Medical Imaging

Background:

  • Mitral annular calcification (MAC) is a common finding in patients with end-stage renal disease (ESRD).
  • The prognostic significance of MAC in renal transplant candidates is not well-established.

Purpose of the Study:

  • To determine if mitral annular calcification (MAC) predicts mortality and cardiac disease in patients awaiting renal transplantation.

Main Methods:

  • 140 renal transplant candidates underwent echocardiography and coronary angiography.
  • Significant coronary artery disease (CAD) was defined as >70% stenosis in any major coronary artery.

Main Results:

  • MAC was present in 40% of patients and associated with higher mortality (p=0.04).
  • MAC patients were older, had larger left ventricular dimensions, reduced systolic function, and higher LV filling pressures.
  • Significant CAD was the only independent predictor of MAC (OR 12, p=0.001).
  • Higher levels of plasma calcium, phosphate, troponin T, and NT-proBNP were observed in patients with MAC.

Conclusions:

  • Mitral annular calcification (MAC) is a significant predictor of mortality and coronary artery disease in ESRD patients.
  • MAC is linked to adverse cardiac structural and functional changes, including increased left ventricular cavity size, impaired systolic function, and elevated filling pressures.
Abstract

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