Mitral Annular Calcium Causing Mitral Stenosis

Pressman, Gregg S.; Agarwal, Ashish; Braitman, Leonard E.; Muddassir, Salman

doi:10.1016/j.amjcard.2009.09.042

Cited by 46 publications

(21 citation statements)

References 11 publications

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“…(10) Characterization of MAC progression and identification of predisposing risk factors may help confirm assumptions that MAC is a surrogate for the atherosclerotic process or may implicate alternate mechanistic pathways. We sought to examine the natural history of MAC progression and the hypothesis that the progression of MAC is associated with traditional cardiovascular risk factors within the longitudinal Multi-Ethnic Study of Atherosclerosis (MESA).…”

Section: Introductionmentioning

confidence: 99%

Risk factors associated with the incidence and progression of mitral annulus calcification: The multi-ethnic study of atherosclerosis

Elmariah¹,

Budoff²,

Delaney³

et al. 2013

American Heart Journal

110

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Background Significant cardiovascular morbidity has been associated with mitral annulus calcification (MAC), but limited data exist regarding its progression. The purpose of this study was to examine the natural history of and risk factors for MAC progression. Methods The Multi-Ethnic Study of Atherosclerosis (MESA) is a longitudinal cohort study of participants aged 45–84 years without clinical cardiovascular disease who underwent serial cardiac computed tomography studies with quantification of MAC. Regression models were used to identify risk factors associated with MAC incidence and progression. Results Prevalent MAC was observed in 534 of 5,895 (9%) participants. Over a median 2.3 years, 280 (5%) developed incident MAC. After adjustment, age was the strongest predictor of incident MAC (adjusted OR, 2.25 per 10 yrs; 95% CI, 1.97 to 2.58; P<0.0001). Female gender, white ethnicity, body mass index, diabetes, hypertension, hyperlipidemia, serum cholesterol, smoking, and interleukin-6 were also significant predictors of incident MAC. In participants with prevalent MAC, the median rate of change was 10.1 [IQR, −6.7, 60.7] Agatston units (AU)/year. Baseline MAC severity was the predominant predictor of rate of MAC progression (β-coefficient per 10 AU, 0.88; 95% CI, 0.85 to 0.91; P<0.0001), although ethnicity and smoking status possessed modest influence. Conclusions Several cardiovascular risk factors predicted incident MAC, as did female gender. Severity of baseline MAC was the primary predictor of MAC progression, suggesting that, while atherosclerotic processes may initiate MAC, they are only modestly associated with its progression over these time frames.

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Section: Introductionmentioning

confidence: 99%

Risk factors associated with the incidence and progression of mitral annulus calcification: The multi-ethnic study of atherosclerosis

Elmariah¹,

Budoff²,

Delaney³

et al. 2013

American Heart Journal

110

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“…Thus, we previously developed a semiquantitative score that accounts for calcium deposits in the aortic root and valve, mitral valve and annulus, and the submitral apparatus. This score has been validated by direct comparison with calcium scoring by CT scan and has been associated with coronary calcium score [11] and severity and progression of mitral valve disease due to severe annular calcification [27]. …”

Section: Discussionmentioning

confidence: 99%

Periodontal Disease Is an Independent Predictor of Intracardiac Calcification

Pressman

Qasim

Verma

et al. 2013

BioMed Research International

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Background. Periodontitis is the most common chronic inflammatory condition worldwide and is associated with incident coronary disease. Hypothesis. We hypothesized that periodontal disease would also be associated with cardiac calcification, a condition which shares many risk factors with atherosclerosis and is considered a marker of subclinical atherosclerosis. Methods. Cross-sectional study at two sites (USA and Japan) involving subjects with both clinical echocardiograms and detailed dental examinations. Semiquantitative scoring systems were used to assess severity of periodontal disease and echocardiographic calcification. Results. Fifty-six of 73 subjects (77%) had cardiac calcifications, and 51% had moderate to severe periodontal disease (score > 2). In unadjusted analysis, a significant relationship between periodontal score and cardiac calcification (Spearman rho = 0.4, P = 0.001) was noted, with increases in mean calcification score seen across increasing levels of periodontal disease. On multivariate logistic regression, adjusted for age, gender, race, glomerular filtration rate, and traditional risk factors, this association remained significant (P = 0.024). There was no significant interaction by study site, race, or gender. Conclusions. In a multiracial population, we found a significant association between the degree of periodontal disease, a chronic inflammatory condition, and cardiac calcification. Further, higher periodontal scores were associated with greater degrees of calcification.

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“… 12 This scoring system assesses calcification of the aortic valve and root, mitral annulus, mitral valve, and subvalvular apparatus, and also takes into account any valvular restriction. It has been found to correlate with coronary calcium score by computed tomography and to predict progression of mitral valve gradient in cases of severe mitral annular calcification 12,13 . An experienced echocardiographer blinded to all clinical information and the assigned study group, reviewed the echocardiograms and assigned a calcium score based on this system.…”

Section: Methodsmentioning

confidence: 99%