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Clinical and Hemodynamic Implications of Mitral Annular Calcification

Andrea Faggiano1, Bianca Rocca2, Chi Young Shim3

  • 1Department of Cardio-Thoracic-Vascular Diseases, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy.

Journal of the Heart Valve Society
|November 28, 2025
PubMed

Insights

Mitral annular calcification (MAC), an inflammatory process, is linked to cardiovascular risks and death. Severe MAC can cause valve dysfunction and symptoms like shortness of breath.

Area of Science:

  • Cardiovascular Medicine
  • Pathology

Background:

  • Mitral annular calcification (MAC) is an inflammatory process resembling atherosclerosis, involving calcium deposition in the mitral valve's fibrous ring.
  • MAC is prevalent in older individuals and those with chronic kidney disease.
  • It serves as a prognostic indicator for cardiovascular events, atrial fibrillation, and mortality.

Purpose of the Study:

  • To detail the characteristics and implications of mitral annular calcification.
  • To explore the association of MAC with cardiovascular dysfunction and patient symptoms.

Main Methods:

  • Review of existing literature on mitral annular calcification.
  • Analysis of MAC's pathological features and clinical associations.

Main Results:

  • Severe MAC can lead to mitral stenosis and/or regurgitation.
  • MAC is associated with impaired left atrial and ventricular compliance.
  • Disruption of left ventricular vortex formation and increased energy loss are linked to MAC.

Conclusions:

  • MAC contributes to valvular dysfunction and altered cardiac mechanics.
  • These mechanical changes may explain symptoms such as dyspnea and exercise intolerance in patients with MAC.

Keywords:
Mitral annular calcificationanatomic distributioncardiovascular outcomeshemodynamic effects

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