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Mitral stenosis is a heart condition in which the mitral valve, which allows blood to flow from the left atrium to the left ventricle, becomes narrowed or stenotic. This narrowing hinders blood flow and leads to clinical symptoms requiring specific medical evaluations and management strategies. The following overview outlines the clinical symptoms, assessments, diagnostic findings, prevention methods, and treatments for mitral stenosis.Clinical ManifestationsDyspnea (shortness of breath): This...
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Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...
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Mitral annular calcification in hypertrophic cardiomyopathy.

Daniele Massera1, Yuhe Xia2, Boyangzi Li3

  • 1Hypertrophic Cardiomyopathy Program, NYU Langone Health, New York, NY, United States of America; Leon H. Charney Division of Cardiology, NYU Langone Health, New York, NY, United States of America.

International Journal of Cardiology
|December 1, 2021
PubMed
Summary

Mitral annular calcification (MAC) in hypertrophic cardiomyopathy (HCM) patients is linked to anterior mitral valve displacement and increased risk of left ventricular outflow tract obstruction (LVOTO). Surgical relief of LVOTO in these patients is safe.

Keywords:
AgingEchocardiographyHypertrophic CardiomyopathyValvular Heart Disease

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Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Medical Imaging

Background:

  • Mitral valve anatomy changes can cause left ventricular outflow tract obstruction (LVOTO) in hypertrophic cardiomyopathy (HCM).
  • Mitral annular calcification (MAC) is common in HCM patients, but its role in LVOTO is unclear.

Purpose of the Study:

  • To investigate the association between echocardiographic MAC and anterior mitral valve displacement.
  • To determine if MAC is linked to LVOTO in elderly HCM patients.

Main Methods:

  • Evaluated 304 HCM patients aged ≥ 60 years using echocardiography.
  • Assessed MAC presence, MAC offset distance, and mitral valve displacement.
  • Correlated MAC with systolic anterior motion (SAM) and LVOTO, and analyzed surgical outcomes.

Main Results:

  • MAC was present in 46% of patients and associated with increased rates of SAM and LVOTO.
  • Patients with MAC showed greater anterior mitral valve displacement.
  • MAC offset distance independently predicted LVOTO (OR 1.16 per mm).

Conclusions:

  • MAC is a geometrical alteration contributing to LVOTO in HCM.
  • Surgical LVOTO relief in MAC patients is safe when performed by experienced surgeons.