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Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation
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Mitral annular calcification progression and the risk of atrial fibrillation: results from MESA

Wesley T O'Neal1, Jimmy T Efird2, Saman Nazarian3

  • 1Department of Medicine, Division of Cardiology, Emory University of School of Medicine, 101 Woodruff Circle, Woodruff Memorial Building, Atlanta, GA 30322, USA.

European Heart Journal. Cardiovascular Imaging
|May 2, 2017
PubMed

Insights

Progression of mitral annular calcium (MAC) detected by cardiac CT significantly increases atrial fibrillation (AF) risk. Follow-up MAC measurements offer crucial prognostic information for AF prediction.

Area of Science:

  • Cardiology
  • Radiology
  • Epidemiology

Background:

  • Atrial fibrillation (AF) is a common arrhythmia with significant health implications.
  • Mitral annular calcium (MAC) is a marker of cardiovascular disease.
  • The predictive value of MAC progression for incident AF is not well established.

Purpose of the Study:

  • To investigate whether progression of mitral annular calcium (MAC) detected by cardiac computed tomography (CT) predicts incident atrial fibrillation (AF).

Main Methods:

  • Analysis of 5683 participants from the Multi-Ethnic Study of Atherosclerosis.
  • MAC measured by cardiac CT at baseline and follow-up.
  • AF ascertained through hospital records and Medicare claims data.
  • Cox regression analysis to assess the association between MAC progression and AF risk.

Main Results:

  • Over 8.6 years median follow-up, 533 (9.4%) incident AF cases were detected.
  • Any MAC progression was associated with a 50% increased risk for AF (HR=1.50, 95% CI=1.20-1.87), adjusted for multiple confounders.
  • No significant interactions were found between MAC progression and AF risk by age, sex, or race/ethnicity.

Conclusions:

  • Follow-up MAC measurement provides important prognostic information for AF risk.
  • MAC progression is associated with a substantively greater risk of AF compared to no progression.
  • MAC progression may indicate underlying left atrial abnormalities predisposing to AF.
Abstract

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