Mitral annular calcification. Clinical and echocardiographic correlations

Area of Science:

• Cardiology
• Medical Imaging

Background:

• Mitral annular calcification (MAC) is a cardiovascular condition with diverse etiologies.
• Clinical presentations of MAC can overlap with other cardiac diseases, necessitating accurate diagnostic methods.

Purpose of the Study:

• To present clinical, echocardiographic, and radiographic findings in patients with mitral annular calcification.
• To evaluate the sensitivity of echocardiography in detecting MAC and differentiating its causes.

Main Methods:

• Retrospective analysis of 41 patients with diagnosed mitral annular calcification.
• Review of clinical diagnoses, echocardiographic data, and radiographic findings (x-ray, cinefluoroscopy).

Main Results:

• Common clinical diagnoses included rheumatic heart disease (32%), noninflammatory calcific disease (34%), and chronic renal failure (32%).
• Echocardiography identified MAC as a dense echo band beneath the posterior mitral leaflet.
• Radiographic detection of MAC was limited (5% on x-ray, 38% on cinefluoroscopy).
• Echocardiography revealed enlarged left atria and thickened mitral leaflets with reduced motion in rheumatic cases, contrasting with preserved motion in nonrheumatic cases.

Conclusions:

• Echocardiography is a sensitive tool for detecting mitral annular calcification.
• Echocardiographic findings can aid in differentiating between rheumatic and nonrheumatic mitral annular calcification.
• MAC is associated with conditions such as idiopathic hypertrophic subaortic stenosis, chronic renal failure, and bacterial endocarditis.