Mitral Annular Calcification Detected by Transthoracic Echocardiography is a Marker for High Prevalence and Severity of Angiographically Proven Coronary Artery Disease

Abstract

Background: MAC was defined as a dense, localized, highly reflective area at the base of the posterior mitral leaflet detected by TTE. Obstructive CAD was defined as either 50% reduction of the internal diameter of the left main coronary artery or 70% reduction of the internal diameter of the left anterior descending, right coronary, or left circumflex artery distribution. Objective: The aim of the study was to evaluate the role of echocardiographically detected MAC as a predictor of coronary artery disease (CAD).Material & Methods:In this prospective, observational, case-control study, coronary angiography was done in 50 patients with MAC and equal number of patients without MAC, detected with transthoracic echocardiography. Analysis was done to observe the association and correlation of MAC with angiographic findings.Results:Mean age of the case control was 55.16 ± 10.73 years and control was 49.80 ± 8.84 years. In this study 34% of patients with MAC and 32% patients without MAC had single vessel disease, 16% of patients with MAC and 24% patients without MAC had double vessel disease, 42% of patients with MAC and 22% patients without MAC had triple vessel disease (TVD), 16% of patients with MAC and 4% patients without MAC had Left main coronary artery disease and 8% of patients with MAC and 22% patients without MAC had no significant CAD.Multivariate analysis shows MAC (p=0.049) as an independent predictor for coronary artery disease (CAD).Conclusions:Transthoracic echocardiographically detected MAC is an independent predictor of coronary artery disease. The low cost, portable and radiation free nature of the ultrasound approach make MAC an attractive parameter in the ongoing search for the ideal marker of coronary artery disease (CAD).