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The Relationship of Mitral Annular Calcification and Aortic Valve Sclerosis to Endothelial Dysfunction

Mohammed N Elganainy1, Mohamad H Farrag1, Ehab N Selim1

  • 1Cardiovascular Medicine, National Heart Institute, Cairo, EGY.

Cureus
|June 6, 2024
PubMed

Insights

Mitral annular calcification (MAC) and aortic valve sclerosis (AVS) are linked to increased carotid intima-media thickness (CIMT), indicating a connection to systemic atherosclerosis. Further research is needed to understand the cardiovascular implications of these valvular calcifications.

Area of Science:

  • Cardiovascular Medicine
  • Vascular Biology
  • Echocardiography

Background:

  • Calcific aortic valve disease (CAVD) and mitral annular calcification (MAC) are associated with cardiovascular diseases and systemic vascular pathologies.
  • The relationship between MAC, aortic valve sclerosis (AVS), and markers of vascular dysfunction like carotid intima-media thickness (CIMT) and endothelial function is not well understood.

Purpose of the Study:

  • To investigate the associations between MAC, AVS, and vascular dysfunction markers, specifically CIMT and endothelial function.
  • To explore the link between valvular calcifications and subclinical atherosclerosis.

Main Methods:

  • Prospective observational study of 200 patients undergoing echocardiography.
  • Stratification into isolated MAC, isolated AVS, combined MAC and AVS, and control groups.
  • Assessment of CIMT and endothelial function using carotid duplex ultrasonography and reactive hyperemia testing.

Main Results:

  • Patients with isolated AVS, isolated MAC, and combined MAC and AVS showed increased CIMT compared to controls.
  • The combined MAC and AVS group had significantly higher CIMT than controls (p=0.031).
  • AVS was associated with a higher likelihood of increased CIMT (p=0.008); endothelial dysfunction was not significantly different across groups.

Conclusions:

  • MAC and AVS are associated with increased CIMT, suggesting a role in systemic atherosclerotic processes.
  • While endothelial dysfunction was not significantly elevated, findings highlight the need for further cardiovascular research in CAVD and MAC.
  • The study underscores the connection between valvular calcification and subclinical vascular changes.
Abstract

Keywords:
aortic valve sclerosiscarotid intima-media thicknessechocardiographyendothelial dysfunctionmitral annular calcificationvascular ultrasound

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