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Mitral Annular Calcification

Carson Oprysko1, Chinmayi Prabhakar2, Lorin Berman1

  • 1From the Department of Cardiology, Nassau University Medical Center, East Meadow, NY.

Cardiology in Review
|April 30, 2026
PubMed

Insights

Mitral annular calcification (MAC), linked to aging and cardiovascular risks, affects 8-15% of people. It increases risks for heart problems and mortality, requiring careful management.

Area of Science:

  • Cardiology
  • Gerontology
  • Medical Imaging

Background:

  • Mitral annular calcification (MAC) is a chronic, age-related degenerative process affecting the posterior mitral annulus.
  • Pathogenesis involves cardiovascular risk factors, mechanical stress, and inflammation, leading to pathological cellular changes.
  • MAC affects 8-15% of the population, with 8% developing significant valvular disease.

Purpose of the Study:

  • To review the epidemiology, pathogenesis, clinical significance, and diagnostic modalities of mitral annular calcification.
  • To highlight the association of MAC with cardiovascular mortality and complications.
  • To discuss the challenges and multidisciplinary approach in managing MAC, especially concerning valvular interventions.

Main Methods:

  • Literature review of studies on mitral annular calcification.
  • Analysis of epidemiological data and risk factors.
  • Evaluation of diagnostic imaging techniques, including echocardiography and cardiac CT.

Main Results:

  • MAC is prevalent in 8-15% of the population, increasing with age.
  • Patients with MAC face higher risks of cardiovascular mortality, atrial fibrillation, conduction disorders, and atherosclerosis.
  • Transthoracic echocardiogram is the primary diagnostic tool; cardiac CT aids in severity quantification and procedural planning.

Conclusions:

  • MAC is a significant cardiovascular risk marker associated with adverse outcomes.
  • Early diagnosis and risk factor management are crucial.
  • A multidisciplinary approach is essential for managing patients with clinically significant MAC, particularly before valvular interventions.
Keywords:
mitral annular calcificationmitral regurgitationmitral stenosis

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