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Sex Differences in Mitral Annular Calcification and the Clinical Implications.
Jiwon Seo1, Hyeonju Jeong2, Iksung Cho1
1Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, South Korea.
Frontiers in Cardiovascular Medicine
|November 1, 2021
Summary
Women experience more severe mitral annular calcification (MAC) and associated risks than men. Significant functional mitral stenosis (MS) independently predicts worse outcomes in MAC patients, particularly women.
Area of Science:
- Cardiology
- Medical Imaging
- Sex Differences in Medicine
Background:
- Mitral annular calcification (MAC) pathogenesis is complex, with limited understanding of sex-based variations.
- Investigating sex differences in MAC prevalence, characteristics, and clinical impact is crucial.
Purpose of the Study:
- To explore clinical and imaging disparities in mitral annular calcification (MAC) between sexes.
- To determine the prognostic significance of mitral stenosis (MS) in relation to sex within the MAC population.
Main Methods:
- Retrospective analysis of 537 patients with MAC identified via transthoracic echocardiography.
- Classification of MAC severity (moderate-to-severe ≥120°) and significant functional mitral stenosis (MS) (mean diastolic gradient ≥5 mmHg).
Main Results:
- Women exhibited higher rates of moderate-to-severe MAC and mitral regurgitation compared to men.
- Logistic regression identified distinct risk factors for severe MAC in women (age, hypertension, ESRD, HCM) versus men (ESRD, aortic stenosis).
- Significant functional MS correlated with all-cause mortality in both sexes, with a stronger independent association observed in women.
Conclusions:
- Women present with more extensive mitral annular calcification (MAC) than men.
- Significant functional mitral stenosis (MS) is an independent predictor of adverse outcomes in MAC patients, with a more pronounced effect in women.
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