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Mitral Annular Calcification, a Not So Marginal and Relatively Benign Finding as Many of Us Think: A Review
András Vereckei1, Zsigmond Jenei1, Hajnalka Vágó2
1Department of Medicine and Hematology, Semmelweis University, Szentkirályi u. 46, 1088 Budapest, Hungary.
Journal of Cardiovascular Development and Disease
|June 25, 2025
Summary
Mitral annular calcification (MAC) is often overlooked but linked to increased cardiovascular risks and poorer outcomes. Emerging evidence highlights its significance beyond an incidental finding.
Area of Science:
- Cardiology
- Medical Imaging
- Pathophysiology
Background:
- Mitral annular calcification (MAC) is typically viewed as a benign, age-related finding.
- Severe MAC can lead to mitral regurgitation or stenosis.
- It is often considered an incidental finding in cardiovascular and pulmonary evaluations.
Purpose of the Study:
- To review the accumulating evidence associating MAC with cardiovascular events.
- To discuss predisposing conditions and pathogenetic mechanisms of MAC.
- To highlight the impact of MAC on cardiovascular interventions and outcomes.
Main Methods:
- Review of existing literature and evidence.
- Analysis of associations between MAC and various cardiovascular conditions.
- Examination of risk factors and predisposing conditions for MAC.
Main Results:
- MAC is associated with increased risk of atherosclerotic diseases, stroke, atrial fibrillation, heart failure, and mortality.
- Conditions like hypertension, diabetes, smoking, and inflammation are linked to MAC.
- Congenital disorders affecting connective tissue also predispose to MAC.
Conclusions:
- MAC is not merely an incidental finding but a significant marker of cardiovascular risk.
- Understanding MAC's associations and pathogenesis is crucial for patient management.
- MAC influences the outcomes of mitral valve interventions, necessitating careful consideration.
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