Impact of Mitral Annular Calcification on the Extent of Coronary Arteries Disease in Ischemic Patients

Abstract

The aim of the present study was to make a co-relation between the degree of mitral annulus calcification and the extent of coronary artery disease in ischemic patients. 60 patients were included in our study with positive coronary angiography results. We excluded patients with normal coronary angiography, rheumatic valvular disease, previous IEC, prosthetic mitral and aortic valves, renal impermanent, chronic renal failure and patients with HOCM. 60 patients were scheduled in Ain shams University Hospital and NHI from September 2010 till September 2013 and were subjected to full history taking, risk stratification, clinical examination, laboratory investigations and Echocardiographic imaging searching for the presence and the degree of Mitral annulus calcification (MAC). Their mean age was 64.88 ± 3.60. 78.3 % of the patients were males. Patients were classified into mild MAC group (14 patients), moderate MAC group (27 patients) and severe MAC group (19 patients). There was no intergroup significant statistical difference regarding age, sex, laboratory investigation, hypertension and smoking, but there was significant difference regarding diabetes mellitus (p< 0.004) and dyslipidemia (p<0.001).

With studying the co-relation statistically the degree of mitral annular calcification had an impact on the presence of severe coronary stenosis with high duke’s scoring for coronary arteries in patients with moderate and severe mitral annular calcification (p value < 0.001 and < 0.001 respectively). The degree of MAC had more impact on the diagonals, septals (p<0.013), LCX (p<0.001), OM (p<0.005) and the RCA (p<0.004). Thus a significant association of mitral annular calcification with known major risk factors for coronary disease may partly explain the association of mitral annular calcification with significant obstructive coronary artery disease on angiography.