Related Experiment Video

Updated: May 10, 2026

Calcification of Vascular Smooth Muscle Cells and Imaging of Aortic Calcification and Inflammation
08:43

Calcification of Vascular Smooth Muscle Cells and Imaging of Aortic Calcification and Inflammation

Published on: May 31, 2016

20.5K

Mitral Annular Calcification-Related Mitral Stenosis: 5-Year Outcomes and Prognostic Determinants in the JAMAC Study

Nahoko Kato1, Takatomo Watanabe2, Takuma Ishihara3

  • 1Department of Cardiology, Tokyo Bay Urayasu/Ichikawa Medical Center, Urayasu, Japan.

Journal of the American College of Cardiology
|March 4, 2026
PubMed

Insights

Mitral annular calcification (MAC)-related mitral stenosis has a poor 5-year prognosis, with 57% survival. Calcific mitral stenosis, particularly with severe MAC, drives noncardiac mortality, highlighting stenosis severity as a key predictor.

Area of Science:

  • Cardiology
  • Echocardiography
  • Clinical Outcomes Research

Background:

  • Mitral annular calcification (MAC)-related mitral stenosis is linked to increased mortality, but long-term outcomes require further clarification.
  • Understanding the specific prognostic factors and causes of death is crucial for managing this high-risk patient group.

Purpose of the Study:

  • To investigate the 5-year outcomes in patients with MAC-related mitral stenosis.
  • To identify causes of death and valve-related prognostic factors associated with MAC-related mitral stenosis.

Main Methods:

  • A retrospective, multicenter study (JAMAC) analyzed adult patients with MAC and mitral stenosis (transmitral mean gradient ≥5 mm Hg).
  • Etiology of mitral stenosis, mitral valve area (MVA), and severity of anterior and posterior MAC were assessed.
  • Multivariable analysis was used to determine valve-related prognostic factors for mortality.

Main Results:

  • The study included 264 patients; 76% had calcific mitral stenosis. Five-year survival was 57%, with higher mortality in calcific versus rheumatic mitral stenosis.
  • Anterior MAC and severe posterior MAC were associated with increased mortality. MVA <1.5 cm² predicted mortality in calcific mitral stenosis.
  • Multivariable analysis identified MVA as an independent predictor of mortality (adjusted HR: 1.56), alongside age and chronic kidney disease.

Conclusions:

  • MAC-related mitral stenosis carries a poor prognosis, characterized by a 5-year survival rate of 57%.
  • Noncardiac mortality predominantly drives outcomes in calcific mitral stenosis.
  • The severity of mitral stenosis is an independent predictor of mortality in this high-risk population.
Abstract

Keywords:
calcific mitral stenosisdegenerative mitral stenosisechocardiographymitral annular calcificationmitral valve arearheumatic mitral stenosis

More Related Videos

Lumped-Parameter and Finite Element Modeling of Heart Failure with Preserved Ejection Fraction09:20

Lumped-Parameter and Finite Element Modeling of Heart Failure with Preserved Ejection Fraction

Published on: February 13, 2021

7.1K
Author Spotlight: Enhancing Graft Viability Assessment Through Quantitative Metrics and Innovative Reservoir Systems08:49

Author Spotlight: Enhancing Graft Viability Assessment Through Quantitative Metrics and Innovative Reservoir Systems

Published on: August 2, 2024

1.4K

Related Concept Videos

Mitral Valve Prolapse I: Introduction01:27

Mitral Valve Prolapse I: Introduction

IntroductionThe mitral valve, one of the heart's four valves, regulates blood flow. These valves have flaps that open and close to direct blood properly through the heart and body. During each heartbeat, the flaps open for blood to pass through and seal shut to prevent backflow. Specifically, the mitral valve opens to allow blood flow from the heart's upper left chamber to the lower left chamber. It then closes securely as the lower left chamber contracts to pump blood to the body, preventing...
Mitral Valve Prolapse II: Assessment and Management01:22

Mitral Valve Prolapse II: Assessment and Management

IntroductionA range of clinical features characterizes Mitral Valve Prolapse (MVP), but it is important to note that many individuals with MVP are asymptomatic and may remain so throughout their lives. For those who do exhibit symptoms, the following are the key clinical features:Palpitations: This is a common symptom where individuals feel an irregular or rapid heartbeat. Palpitations in MVP are often due to arrhythmias such as premature ventricular contractions or supraventricular tachycardia.
Mitral Regurgitation III: Medical Management01:25

Mitral Regurgitation III: Medical Management

Mitral regurgitation (MR) is characterized by retrograde blood circulation from the left ventricle into the left atrium due to inadequate mitral valve closure. The severity of the condition, symptoms, and underlying cause determine treatment strategies.Monitoring and Pharmacological TreatmentPatients with mild to moderate MR typically do not need immediate intervention but regular monitoring to assess progression and guide treatment. Patients with mild MR should have an echocardiogram every 3-5...
Mitral Stenosis I: Introduction01:22

Mitral Stenosis I: Introduction

Mitral Valve Stenosis (MVS) is a heart condition where the mitral valve narrows, impeding blood circulation from the left atrium to the left ventricle. The etiology and pathophysiology of this condition are multifaceted, leading to a cascade of cardiovascular complications.Causes of Mitral Valve StenosisRheumatic Heart Disease: It is the main cause of mitral valve stenosis, particularly in developing nations. This condition arises from rheumatic fever, an inflammatory illness resulting from...
Mitral Stenosis II: Clinical features and Diagnostic Tests01:23

Mitral Stenosis II: Clinical features and Diagnostic Tests

Mitral stenosis is a heart condition in which the mitral valve, which allows blood to flow from the left atrium to the left ventricle, becomes narrowed or stenotic. This narrowing hinders blood flow and leads to clinical symptoms requiring specific medical evaluations and management strategies. The following overview outlines the clinical symptoms, assessments, diagnostic findings, prevention methods, and treatments for mitral stenosis.Clinical ManifestationsDyspnea (shortness of breath): This...
Mitral Stenosis III: Medical Management01:26

Mitral Stenosis III: Medical Management

Mitral stenosis, a condition marked by the narrowing of the mitral valve, necessitates an integrated approach for effective management. This approach includes preventative measures, medical therapy, and surgical interventions to reduce symptoms and prevent complications.PreventionPrevention of mitral stenosis primarily focuses on reducing the incidence of bacterial infections, particularly streptococcal infections, which can lead to rheumatic fever and subsequent valvular damage. Timely...