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Comparative Study on Clinical and Echocardiographic Findings in Ischemic Heart Disease Patients with or without
M D Hoda1, M E Hossain, C M Ahmed
1Dr Md Durul Hoda, Assistant Professor, Department of Cardiology, Shaheed Tazuddin Ahmad Medical College, Gazipur, Bangladesh;
Insights
Mitral annular calcification (MAC), detected via echocardiography, is strongly associated with ischemic heart disease (IHD). This non-invasive marker aids in identifying patients with IHD, offering a valuable tool for cardiovascular risk assessment.
Area of Science:
- Cardiology
- Diagnostic Imaging
- Medical Research
Background:
- Cardiac valve calcification, including mitral annular calcification (MAC), involves bright resonance in heart valve structures.
- MAC is identified on echocardiography as an intense echo-producing structure at the atrioventricular groove and posterior mitral valve leaflet junction.
Purpose of the Study:
- To investigate the association between Mitral Annular Calcification (MAC) and clinical/echocardiographic findings in ischemic heart disease (IHD).
- To evaluate the role of transthoracic echocardiography in detecting MAC as a potential marker for IHD.
Main Methods:
- A prospective, observational, case-control study involving 100 IHD patients (50 with MAC as cases, 50 without MAC as controls).
- Data collection included patient history, clinical examination, and relevant investigations.
- MAC detection was performed using transthoracic echocardiography.
Main Results:
- MAC was most prevalent (56.0%) in the 45-60 age group.
- Diabetes mellitus (p=0.006), hypertriglyceridemia, and low HDL were significantly higher in the MAC group.
- Regional wall motion abnormality (RWMA) was observed in 52.0% of cases versus 32.0% of controls.
Conclusions:
- Transthoracic echocardiographically detected MAC is an independent predictor of Ischemic Heart Disease (IHD).
- The low cost, portability, and radiation-free nature of echocardiography make MAC detection an attractive parameter for identifying IHD.
Abstract:
The presence of bright resonance of more than 1 mm or more cusps of the aortic valve, mitral valve or mitral annulus is termed as cardiac valve calcification. If an intense echo producing structure located at the junction of the atrioventricular groove and posterior mitral valve leaflet on Echocardiography that is Mitral annular calcification (MAC). This study was conducted to observe the association of MAC with clinical and echocardiographic findings of ischemic heart disease (IHD) and the role of trans-thoracic echocardiography to detect MAC which is a marker IHD. In this prospective, observational, case-control study, total of 100 IHD patients, 50 patients with MAC were assigned as case group and 50 patients without MAC were control group after fulfilling inclusion criteria. All the detailed history, clinical examination and relevant investigation reports of each patient were recorded in pre designed data collection sheet. MAC was detected with transthorasic echocardiography. Analysis was done to observe the association and correlation of MAC with clinical findings of IHD. Mean age of the case control was 55.16±10.73 years and control was 49.80±8.84 years. MAC was noted highest about 56.0% in between age 45 to 60 years. Eighty two percent (82.0%) of cases and 84.0% of controls were male, 18.0% of cases and 16.0% of controls were female. BMI among the MAC group 2.0% were underweight, 72.0% normal, 24.0% over weight and 2.0% were obese and among non MAC controls group 10.0% were underweight, 68.0% normal, 20.0% over weight and 2.0% were obese. Clinically among cases 14(28.0%) had Stable angina, 8(16.0%) had UA, 3(6.0%) had Non STEMI, 2(4.0%) had AMI, 2(4.0%) had Recent myocardial infarction and 21(42.0%) had OMI. Diabetes mellitus was significantly higher in the case groups (p=0.006). Significant p-value was noted in hyper-triyglyceridemia and low HDL in case group than control. Echocardiographic studies showed 52.0% of cases and 32.0% of controls had regional wall motion abnormality (RWMA). Transthorasic echocardiographically detected MAC is an independent predictor of Ischemic heart disease. The low cost, portable and radiation free nature of the ultrasound approach make MAC an attractive parameter in the ongoing search for IHD.
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