Characteristic and outcome of patients with mitral annular calcifications

Mitral annular calcification (MAC) prevalence is increasing. It is associated with cardiovascular events and mitral valve dysfunction. This study examined outcome of patients with MAC. Methods: SHARE (Sheba HeArt RegistEry) is an historical retrospective cohort of all patients evaluated at Leviev Heart center between 2007 and 2019. The current analysis includes all patients who underwent echocardiographic evaluation. Data on MAC were extracted for all patients from the echocardiographic reports. Primary outcome was all cause mortality and was available for all patients from the Israeli Population Register. Results: Final cohort included 97,561 subjects, of whom 42,280 (43%) were outpatients. Mean age was 66±17 and 55,976 (57%) were men. MAC was demonstrated in 8,612 (9%) of patients who were older (78 vs. 66), more likely to be women (50% vs. 43%) and had higher estimated pulmonary pressure (40 vs. 35 mmHg; pesults such that patients with MAC (N=4,720) were 9% more likely to die (95% CI 1.02-1.16, p = .008). Finally, a regression analysis of the impact of mean mitral pressure gradient on mortality was performed and showed no independent association between mean or peak gradients across the mitral valve and overall survival of patients with MAC. Conclusions: MAC is a marker of poor survival, but the mitral gradient in this population is not independently associated with worse survival.