Association of mitral annular calcification and aortic valve morphology: a substudy of the aortic stenosis progression observation measuring effects of rosuvastatin (ASTRONOMER) study

Jassal, Davinder S.; Tam, James W.; Bhagirath, Kapil M.; Gaboury, Isabelle; Sochowski, Randall A.; Dumesnil, Jean G.; Giannoccaro, Peter; Jue, John; Pandey, A. Shekhar; Joyner, Campbell; Teo, Koon; Chan, Kwan L.

doi:10.1093/eurheartj/ehn172

Cited by 43 publications

(35 citation statements)

References 23 publications

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“…Our finding that MAC is less prevalent in the patients with bicuspid AVS coincides to the previous studies. Jassal and associates [21] showed that, in patients with asymptomatic mild to moderate AVS, those with tricuspid aortic valves had more extensive MAC compared to those with bicuspid aortic valves, using transthoracic echocardiography. Roberts and colleagues [22] reported that MAC was less frequent in those with unicuspid and bicuspid valves than in those with tricuspid valves (19,20, and 61 %) at necropsy of 260 patients with AVS without operative therapy.…”

Section: Discussionmentioning

confidence: 99%

Mitral annular calcification in patients undergoing aortic valve replacement for aortic valve stenosis

Takami

Tajima

2014

Heart Vessels

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Limited data exis t on clinical relevance of aortic valve stenosis (AVS) and mitral annular calcification (MAC), although with similar pathophysiologic basis. We sought to reveal the prevalence of MAC and its clinical features in the patients undergoing aortic valve replacement (AVR) for AVS. We reviewed 106 consecutive patients who underwent isolated AVR from 2004 to 2010. Before AVR, CT scans were performed to identify MAC, whose severity was graded on a scale of 0-4, with grade 0 denoting no MAC and grade 4 indicating severe MAC. Echocardiography was performed before AVR and at follow-up over 2 years after AVR. MAC was identified in 56 patients with grade 1 (30 %), 2 (39 %), 3 (18 %), and 4 (13 %), respectively. Patients with MAC presented older age (72 ± 8 versus 66 ± 11 years), higher rate of dialysis-dependent renal failure (43 versus 4 %), and less frequency of bicuspid aortic valve (9 versus 36 %), when compared to those without MAC. No significant differences were seen in short- and mid-term mortality after AVR between the groups. In patients with MAC, progression of neither mitral regurgitation nor stenosis was observed at follow-up of 53 ± 23 months for 102 survivors, although the transmitral flow velocities were higher than in those without MAC. In conclusion, MAC represented 53 % of the patients undergoing isolated AVR for AVS, usually appeared in dialysis-dependent elder patients with tricuspid AVS. MAC does not affect adversely upon the survival, without progression of mitral valve disease, at least within 2 years after AVR.

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Section: Discussionmentioning

confidence: 99%

Mitral annular calcification in patients undergoing aortic valve replacement for aortic valve stenosis

Takami

Tajima

2014

Heart Vessels

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“…The aortic valve annulus diameter (mm) was measured using transesophageal echocardiography (TEE) in the long-axis view. Aortic valve calcification relied on visualization of bright echoes at the base of the aortic valve leaflets using TEE, and was graded as mildly calcified when calcification appeared as small isolated spots, moderately calcified when multiple larger spots were present, and heavily calcified when extensive thickening and calcification of all cusps was seen (8). The thickness of both the noncoronary cusp (NCC) and the right coronary cusp was measured in the long-axis view using TEE.…”

Section: Methodsmentioning

confidence: 99%

Anatomic and Procedural Predictors of Paravalvular Aortic Regurgitation After Implantation of the Medtronic CoreValve Bioprosthesis

Sherif

Abdel‐Wahab

Stöcker

et al. 2010

Journal of the American College of Cardiology

242

174

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“…Jassal et al 27 reported the close relationship between mitral annular calcification and aortic valve calcification in patients with aortic stenosis. We did not assess the effects of mitral annular calcification, but the relationship between mitral regurgitation and progression of early-stage CAVD may be partly explained by the previous finding.…”

Section: Prognostic Factors For Progression Of Early-stage Cavdmentioning

confidence: 99%

Prognostic factors for progression of early- and late-stage calcific aortic valve disease in Japanese: The Japanese Aortic Stenosis Study (JASS) Retrospective Analysis

Yamamoto

Yoshida

et al. 2010

Hypertens Res

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Calcific aortic valve disease (CAVD) is the most common etiology of acquired valvular heart disease, and hypertension is a principal underlying disease. The Japanese Aortic Stenosis Study (JASS) Retrospective Analysis is a retrospective observational study to clarify the prognostic factors for progression of CAVD in Japanese. Data from 556 subjects who met the following criteria were analyzed: (1) X50 years old; (2) calcification in any aortic valve leaflet or peak aortic jet velocity X2 m s À1 on an echocardiographic study performed between July 2004 and June 2007; and (3) availability of earlier echocardiographic data from within the previous 2-5 years to assess the progression of CAVD. The subjects were divided into two groups according to CAVD severity on the preceding echocardiographic examination. In early-stage subjects with calcification in one or zero leaflets who were without aortic stenosis on the preceding echocardiographic study (n¼157), the prognostic factors for progression were the following: (1) no use of angiotensin receptor blockers (ARB) and (2) use of warfarin. In late-stage subjects with calcification in two or three leaflets and/or aortic stenosis on the preceding echocardiographic study (n¼399), progression was observed in females and in subjects with low hemoglobin and a concentric left ventricle. There was no relation between medications and changes in CAVD. Prognostic factors for the progression of CAVD were different between the early and late stages. Initiation of ARB treatment during the early stage may be effective, and we should be vigilant about progression of CAVD in patients treated with warfarin.

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Association of mitral annular calcification and aortic valve morphology: a substudy of the aortic stenosis progression observation measuring effects of rosuvastatin (ASTRONOMER) study

Cited by 43 publications

References 23 publications

Mitral annular calcification in patients undergoing aortic valve replacement for aortic valve stenosis

Mitral annular calcification in patients undergoing aortic valve replacement for aortic valve stenosis

Anatomic and Procedural Predictors of Paravalvular Aortic Regurgitation After Implantation of the Medtronic CoreValve Bioprosthesis

Prognostic factors for progression of early- and late-stage calcific aortic valve disease in Japanese: The Japanese Aortic Stenosis Study (JASS) Retrospective Analysis

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