Mitral annular calcification: A marker of severe coronary artery disease in patients under 60 years old

  • Md. Babul Mia Assistant Professor (Cardiology), Chandpur Medical College, Chandpur, Bangladesh
  • Md. Rezaul Karim Assistant Professor (Cardiology), Rajshahi Medical College, Rajshahi, Bangladesh
  • Nur Hossain Ex-Professor and Head, Department of Cardiology, Sir Salimullah Medical College, Dhaka, Bangladesh
  • Md. Jahurul Haque Ex-Associate Professor (Cardiology), Sir Salimullah Medical College, Dhaka, Bangladesh
  • Tariq Ahmed Chowdhury Assistant Professor (Cardiology), National Institute of Cardio Vascular Disease, Dhaka, Bangladesh
  • Sania Hoque Assistant Professor, Department of Cardiology, Kurmitola General Hospital, Dhaka, Bangladesh
Keywords: Mitral Annular Calculation (MAC), Fibrous, Calcification, Mitral Valve Support Ring

Abstract

Background: Mitral Annular calculation (MAC) is a fibrous, degenerative calcification of the mitral valve support ring. Mitral Annular calcification is a common condition. In other population-based study, the prevalence of MAC was reported as 13%. It is more common in women and people over 70 years old. Most previous pathological and clinical studies have proposed that MAC may be a form of atherosclerosis and suggested that coronary atherosclerosis and MAC have similar etiology. Methods: A Cross sectional Study was conducted at Sir Salimullah Medical College & Mitford, Dhaka, Bangladesh. Patients of coronary artery disease with or without MAC who were selected for coronary angiography. Group–1: Patients with mitral annular calcification. Group–2: Patients without mitral annular calcification. Results: Total 79 patients was selected, mean age was 48.94±8.1 years. In MAC group male patients were 41(85.4%) & female 7(14.6%). In no MAC group male patients were 19(61.2%) & female 12(38.8%). Significant sex difference was observed among MAC & no-MAC group (p=0.005). In this study, 66% of patients with MAC and 33% of patient without MAC had single vessel disease, 68% patients with MAC and 32 % without MAC had double vessel disease, 83% of  patient with MAC and 17% patient without MAC had triple vessel disease, and 100% of patient with MAC had left mean coronary artery disease, and 12% of MAC and 88% of patient without MAC had no significant coronary artery disease. Among 2 left main patients, 100% had severe MAC. Among 15 patients of TVD none was mild, 2(20%) moderate and 13(54.1%) had severe MAC. Among 15 patient of DVD   2(13.3%) were mild, 5 (33.4%) moderate and 8(53.3%) had severe MAC. Among 14 patients of SVD 10(71.4%) were mild, 3(30%) moderate and 1(4.2%) had severe MAC. Among 2 patient of non-significant coronary artery disease, 2(14.3%) without CAD had mild MAC and none had moderate and severe MAC. Multivariate analysis shows MAC (p=0.007) as an independent predictor for coronary artery disease. Conclusions: This study finding suggest that  in patient aged less than 60 years, mitral annular calcification associated with an increased prevalence  of severe and extensive  obstructive coronary artery disease. Mitral annular calcification may be an easily detected echocardiographic marker of the presence of obstructive coronary artery disease, especially when associated with angina symptoms.

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CITATION
DOI: 10.26838/MEDRECH.2022.9.6.644
Published: 2022-11-25
How to Cite
1.
Mia MB, Karim MR, Hossain N, Haque MJ, Chowdhury TA, Hoque S. Mitral annular calcification: A marker of severe coronary artery disease in patients under 60 years old. Med. res. chronicles [Internet]. 2022Nov.25 [cited 2024Mar.29];9(6):496-04. Available from: https://medrech.com/index.php/medrech/article/view/629
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Original Research Article