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Risk Factors and Outcomes With Progressive Mitral Annular Calcification
Hee Jeong Lee1, Jiwon Seo2, Seo-Yeon Gwak3
1Division of Cardiology, Department of Internal Medicine, Keimyung University Dongsan Hospital Keimyung University School of Medicine Daegu South Korea.
Journal of the American Heart Association
|September 13, 2023
Summary
Mitral annular calcification (MAC) progression is common and linked to factors like pulse pressure and MAC angle. Progressive MAC indicates poorer clinical outcomes, including mortality and heart failure hospitalizations.
Area of Science:
- Cardiology
- Echocardiography
- Degenerative Diseases
Background:
- Mitral annular calcification (MAC) is a chronic, progressive condition.
- Understanding MAC progression factors and clinical impact is crucial.
Purpose of the Study:
- To investigate factors associated with MAC progression.
- To determine the clinical implications of MAC progression.
Main Methods:
- Retrospective analysis of 138 patients with mild/moderate MAC undergoing follow-up echocardiography.
- Progressive MAC defined by worsened hemodynamic (MDPG) or structural (MAC angle) features.
- Clinical outcomes assessed via all-cause mortality, heart failure hospitalization, and ischemic stroke.
Main Results:
- 31.2% of patients showed progressive MAC.
- Progressive MAC associated with higher pulse pressure, MAC angle, and MDPG.
- Progressive MAC linked to smaller LV end-systolic dimensions and higher LV ejection fractions.
- Pulse pressure, LV ejection fraction, MAC angle, and MDPG predicted MAC progression.
- Progressive MAC patients had significantly poorer clinical outcomes.
Conclusions:
- MAC progression is a frequent finding.
- MAC progression is influenced by structural and hemodynamic factors causing mechanical stress.
- Patients with progressive MAC face adverse clinical outcomes.
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