Valvular & structural heart disease

Mitral Annular Calcification Score Determined by 3-D Transesophageal Echocardiography vs Cardiac Computed Tomography

JACC AdvPublished Secondary analysis of the MITRAL II trial

Primary result · MAC score: correlation and agreement of 3D-TEE vs CTResult — go to the resultSpearman correlation coefficient 0.34

Authors' conclusion

3D-TEE provides complementary and functionally relevant MAC assessment, correlating with MS severity.

Study context

Population
Patients with mitral annular calcification (MAC) undergoing transcatheter mitral valve replacement screening, 13 centres
Participants
164 patients
Comparison
3D-TEE vs computed tomography (CT) MAC score
Methodological detailsmulticentre, core laboratory assessment
  • Multicentre
  • Core laboratory assessment

Primary result

As reported in the abstract

MAC score: correlation and agreement of 3D-TEE vs CT

Spearman correlation coefficient

0.34

P < 0.001

By group

CT

8.0

mean · SD 0.44

3D-TEE

8.2

mean · SD 0.45

Further findings

Haemodynamics per unit increase in 3D-TEE MAC score

3D-TEE mitral valve area decrease
0.15 cm²
2D-TTE mitral valve area decrease
0.05 cm²
Mean diastolic pressure gradient increase, 3D-TEE
1 mm Hg
Mean diastolic pressure gradient increase, 2D-TTE
0.96 mm Hg

Regurgitation parameters vs 3D-TEE MAC score

No significant correlation

Mitral stenosis (MS) and mitral regurgitation vs CT-MAC score

Weak, nonsignificant correlations

Original publication

Mitral Annular Calcification Score Determined by 3-D Transesophageal Echocardiography vs Cardiac Computed Tomography. JACC Adv. Published 17 December 2025. doi:10.1016/j.jacadv.2025.102427

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