Valvular & structural heart disease
Mitral annular calcification in severe aortic stenosis: prognostic value of calcification severity and mitral valve dysfunction
Authors' conclusion
MAC is highly prevalent in patients with severe AS, affecting more than 50%. It is associated with shorter survival, particularly if MAC is severe or the patient also has MVD. These findings highlight the importance of evaluating MAC severity and mTMG in AS patients to guide clinical decisions.
Study context
- Population
- Patients with severe aortic stenosis (AS), categorized by echocardiographic mitral annular calcification (MAC) severity and the presence of mitral valve dysfunction (MVD)patients with severe AS, 309 (50.4%) had MAC
- Participants
- 613 patients
- Exposure
- MAC severity and presence of MVD in patients with severe AS
- MACn = 309
- Outcome
- MAC prevalence
Main finding
As reported in the abstract
Patients with MAC
309 (50.4%) of the 613 patients
Severity among patients with MAC
44% mild, 40% moderate, and 16% severe
Patients with MAC who also displayed MVD
21%
Observational data: associations, not effects.
Further findings
| Outcome | Values | HR (95% CI) | |
|---|---|---|---|
| Survival, MAC vs no MAC · 6 yearsMACvs No MACAfter adjustment for covariates with prognostic impact | 1.24 (1.03–1.67) | ||
| Independent predictors of death (multivariable analysis)Severe MACvs No MACComparator not stated · multivariable analysis | 2.63 (.51-4.60) | ||
| Independent predictors of death (multivariable analysis)MVDvs No MACComparator not stated · multivariable analysis | 1.86 (1.24–2.77) | ||
| 0.20.5125Hazard ratio (log scale) |
| Outcome | Values | P value |
|---|---|---|
| Survival, MAC vs no MAC · 6 yearsMAC vs No MAC | MAC survival 47 ± 3% · No MAC survival 64 ± 3% | P < 0.001 |
| Survival by MAC severity · 6 years | Severe MAC survival 23 ± 7% · Mild MAC survival 55 ± 5% · Moderate MAC survival 50 ± 5% | |
| Survival by MVD among patients with MAC · 6 years | MAC and MVD survival 28 ± 7% · MAC but not MVD survival 53 ± 4% |
Characteristics associated with severe MAC
- Severe MAC associated with being older, being female, higher comorbidity scores, and high pulmonary pressures
- all P < 0.05
Original publication
Mitral annular calcification in severe aortic stenosis: prognostic value of calcification severity and mitral valve dysfunction. Eur Heart J Cardiovasc Imaging. Published 24 July 2025. doi:10.
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