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Association Between Mitral Annular Calcification and Ventricular Tachycardia in Patients with Reduced and Mildly

Müjgan Ayşenur Şahin1, Ahmet Seyda Yılmaz1, Elif Ergül1

  • 1Department of Cardiology, Faculty of Medicine, Recep Tayyip Erdoğan University, Rize 53020, Türkiye.

Journal of Clinical Medicine
|February 13, 2026
PubMed

Insights

Mitral annular calcification (MAC) strongly predicts ventricular tachycardia (VT) in patients with reduced ejection fraction. This finding may improve risk assessment for arrhythmias in heart failure patients.

Area of Science:

  • Cardiology
  • Electrophysiology

Background:

  • Reduced and mildly reduced ejection fraction heart failure (HFrEF/RmrEF) patients are at high risk for ventricular arrhythmias.
  • Mitral annular calcification (MAC) is a common finding in this population, but its association with ventricular tachycardia (VT) requires further investigation.

Purpose of the Study:

  • To evaluate the association between mitral annular calcification (MAC) and ventricular tachycardia (VT) in patients with heart failure and reduced or mildly reduced ejection fraction.
  • To identify independent predictors of VT in this patient cohort.

Main Methods:

  • Retrospective cross-sectional study of 143 patients with heart failure and LVEF < 50%.
  • Patients were categorized based on the presence or absence of VT.
  • Clinical, biochemical, and echocardiographic data were analyzed, with multivariable logistic regression used to identify independent predictors.

Main Results:

  • Mitral annular calcification (MAC) was significantly more prevalent in the VT group (43.6%) compared to controls (17.4%, p < 0.001).
  • MAC was the strongest independent predictor of VT (OR: 2.74; 95% CI: 1.13-6.65; p = 0.026).
  • Other VT predictors included elevated inflammatory markers, low albumin, increased left atrial volume, renal dysfunction, and high diastolic filling pressures.

Conclusions:

  • Mitral annular calcification (MAC) is a significant and independent predictor of ventricular tachycardia (VT) in patients with reduced or mildly reduced ejection fraction.
  • Integrating MAC assessment with other clinical, inflammatory, metabolic, and structural parameters may enhance risk stratification for VT in HFrEF/RmrEF patients.

Keywords:
arrhythmiaheart failureinflammationmitral annular calcificationventricular tachycardia

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