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Mitral Annulus Calcium Score

Yafim Brodov1,2, Eli Konen2, Mattia Di Segni2

  • 1Leviev Heart Center (Y.B., F.C., I.B., E.R., V.G., A.S., P.F., M.G.), Sheba Medical Center, Tel Hashomer, Tel-Aviv University, Israel.

Circulation. Cardiovascular Imaging
|January 15, 2019
PubMed

Insights

Mitral annular calcium (MAC) score predicts conduction system abnormalities (CSA) after transcatheter aortic valve implantation. High MAC scores indicate increased risk for CSA, necessitating closer patient monitoring.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Cardiac Imaging

Background:

  • Transcatheter aortic valve implantation (TAVI) carries a risk of conduction system abnormalities (CSA).
  • Mitral annular calcium (MAC) is a potential factor influencing CSA development post-TAVI.

Purpose of the Study:

  • To assess the predictive value of MAC score for CSA after TAVI.
  • To identify patients at higher risk for CSA following TAVI.

Main Methods:

  • 168 patients with severe aortic stenosis underwent TAVI (CoreValve or SAPIEN).
  • Mitral annular calcium, aortic valve, and left ventricular outflow tract calcium scores were quantified using computed tomography.
  • Primary endpoint: complete left bundle branch block or high-degree atrioventricular block.

Main Results:

  • Patients in the highest MAC score quartile (>2700) had a significantly higher incidence of the primary endpoint (62%) compared to the lowest quartile (<140) (31%).
  • MAC score was an independent predictor of CSA, both as a continuous variable and by quartile.
  • The fourth MAC score quartile was a strong independent predictor of CSA (OR: 3.69).

Conclusions:

  • MAC score is an independent predictor of CSA in TAVI patients without prior conduction abnormalities.
  • Patients with high MAC scores (fourth quartile) are at increased risk for CSA post-TAVI.
  • High MAC score identifies patients requiring closer monitoring after TAVI.
Abstract

Keywords:
aortic valveatrioventricular blockcalciumhumanslogistic models

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