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Risk factors and clinical outcomes associated with mitral annular calcification in hypertrophic obstructive

Bowen Guo1, Bangrong Song1, Xiaoyu Xu2

  • 1Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, People's Republic of China.

Expert Review of Clinical Pharmacology
|January 16, 2026
PubMed

Insights

Mitral annular calcification (MAC) in hypertrophic obstructive cardiomyopathy (HOCM) patients is linked to adverse cardiac remodeling and worse outcomes. Identifying risk factors aids in patient management.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Medical Imaging

Background:

  • Hypertrophic obstructive cardiomyopathy (HOCM) is a complex cardiac condition.
  • Mitral annular calcification (MAC) is a common finding in cardiovascular diseases.
  • The relationship between MAC and outcomes in HOCM patients is not fully understood.

Purpose of the Study:

  • To identify risk factors for mitral annular calcification (MAC) in patients with hypertrophic obstructive cardiomyopathy (HOCM).
  • To evaluate the association between MAC and clinical outcomes in HOCM patients undergoing septal myectomy.

Main Methods:

  • Retrospective analysis of 310 HOCM patients who underwent interventricular septal myectomy.
  • Comparison of demographic, echocardiographic, and clinical data between patients with and without MAC.
  • Multivariate analysis to identify independent risk factors for MAC.

Main Results:

  • Patients with MAC were older and had higher rates of aortic annular calcification, mitral leaflet thickening, and tricuspid regurgitation.
  • Independent risk factors for MAC included gender, age, aortic annular calcification, and mitral/tricuspid valve abnormalities.
  • MAC was associated with adverse cardiac remodeling (larger LV end-diastolic volume, reduced LVEF, greater LA mass) and a higher incidence of major adverse cardiovascular and cerebrovascular events (MACCE).

Conclusions:

  • Mitral annular calcification (MAC) is associated with adverse cardiac remodeling in HOCM patients.
  • MAC is linked to unfavorable clinical outcomes in HOCM patients undergoing septal myectomy.
  • Identifying MAC risk factors can improve risk stratification and perioperative management.
Abstract

Keywords:
Hypertrophic obstructive cardiomyopathyMitral annular calcificationcardiac functionprognosisrisk factors

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