Clinical InvestigationMitral Systolic Anterior Motion and Annulus CalcificationSystolic Anterior Motion of the Mitral Valve in the Presence of Annular Calcification
Section snippets
Subject Pool
We queried our echocardiography database from August 2007 through February 2022 to identify the subjects for this research. We first created a study set comprising all those with both severe MAC and SAM (n = 30). These were compared to 30 subjects with similarly severe MAC but no SAM and 30 control subjects without MAC or SAM. The 2 comparator groups were matched by age (±5 years) and sex. Mitral annular calcification height was defined as the anteroposterior dimension of the bar of
Results
For the entire study group (120 subjects), the mean age was 74 ± 10 years (range, 56-95), and 87% of patients were female. Hypertension was prevalent (79%) as were hyperlipidemia (46%) and diabetes (49%; Table 1). Echocardiographic variables for the different groups are displayed in Table 2. Significant differences were found across groups for coaptation point-septal distance, AML length, LVDD, and EF. Prevalence of an upper septal bump ranged from 47% to 60% in the various groups with no
Discussion
Mitral annular calcification is prevalent in the elderly and those with renal dysfunction. However, calcium deposition in the annulus does not appear to follow a predictable pattern. It can migrate onto the leaflets, reducing their mobility and causing stenosis,12 or distort the leaflets, causing regurgitation.13 In this study we have investigated MAC as a possible promoter of SAM of the mitral valve.
Systolic anterior motion of the mitral valve and dynamic LVOT obstruction occur when the
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Cited by (1)
Defining the Role of Mitral Annular Calcification in Mitral Valve Systolic Anterior Motion
2023, Journal of the American Society of Echocardiography
Conflicts of Interest: None.