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You are here: Contents > 2018-19 > Volume 28 Number 1 (2018-19) > MITRAL VALVE DISEASE > Mitral Annular Calcification as a Risk Marker for Severe Coronary Artery Disease in Patients with Acute Coronary Syndrome

Mitral Annular Calcification as a Risk Marker for Severe Coronary Artery Disease in Patients with Acute Coronary Syndrome

Maryam Nabati1, Ghazal Hatami2, Alireza Salehi2, Mojdeh Dabirian3, Jamshid Yazdani Charati4

1Department of Cardiology, Faculty of Medicine, Cardiovascular Research Center, Mazandaran University of Medical Sciences, Sari, Iran
2Faculty of Medicine, Cardiovascular Research Center, Mazandaran University of Medical Sciences, Sari, Iran
3Department of Cardiology, Faculty of Medicine, Cardiovascular Research Center, Mazandaran University of Medical Sciences, Sari, Iran
4Department of Biostatistics, Health Sciences Research Center Addiction Institute, Faculty of Health, Mazandaran University of Medical Sciences, Sari, Iran
5Electronic correspondence: Dr.mr.nabati@gmail.com

Background and aim of the study: Previous studies have reported a possible association between mitral annular calcification (MAC) and coronary atherosclerosis, though others have described it as a benign age-related finding. The study aim was to assess the association between MAC and the severity of coronary artery disease (CAD) and left ventricular systolic and diastolic dysfunction.

Methods: The study included 200 patients admitted to the authors’ hospital with unstable angina or non-ST-elevation myocardial infarction. All patients underwent transthoracic echocardiography within 24 h after admission. MAC was determined in the parasternal short-axis view and was graded as none, mild, moderate, or severe. The left ventricular ejection fraction (LVEF) and variables of left ventricular diastolic function, including left atrial (LA) diameter, pulsed-wave Doppler transmitral early diastolic velocities (E-wave), tissue Doppler mitral annular early

 

diastolic velocities (e'), and E/e', were also measured. Angiographic variables, including CAD severity and SYNTAX scores were also determined

Results: Patients with MAC had a higher prevalence of diabetes, a further increase in cardiac troponin-I (TnI) levels, a higher prevalence of three-vessel CAD or left main artery disease, and a higher SYNTAX score than those who did not have MAC. The LVEF and e' velocity were lower, and LA diameter was larger. A trend towards a higher E/e' ratio in MAC patients compared to MAC-free patients was also noted.

Conclusion: MAC may be a helpful echocardiographic marker for identifying the presence of severe and complex CAD and predicting left ventricular systolic and diastolic dysfunction in patients suspected of having CAD.

The Journal of Heart Valve Disease 2018-19;28:14-21

Mitral Annular Calcification as a Risk Marker for Severe Coronary Artery Disease in Patients with Acute Coronary Syndrome

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