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MITRAL ANNULAR CALCIFICATION IN ELDERLY PATIENTS. CLINICAL AND ECHOCARDIOGRAPHIC CHARACTERISTICS

https://doi.org/10.20996/1819-6446-2011-7-6-690-697

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Abstract

Background. The clinical significance of idiopathic mitral annular calcification (MAC) often diagnosed by echocardiography in elderly patients currently is not sufficiently studied. Aim. To study the clinical and echocardiographic characteristics of the cardiovascular system in patients with MAC aged 65 and older without diabetes mellitus and renal failure. Material and methods. Study included 100 patients with MAC, consecutively identified by 2D transthoracic echocardiography performed with relation to cardiovascular disease symptoms in 910 outpatients aged 65 years or older; the comparison group included 65 of consecutively studied patients without MAC. Results. Patients with MAC were older than patients without MAC (72.4±5.4 years vs 70.2±4.3 years; p<0.05) and had higher frequency of moderate or severe hypertension (99.0% vs 90.8%, p<0.05), myocardial infarction (adjusted incidence rate [AIR] 1.72; 95% confidence interval [CI] 1.12-2.55; р<0.05) and heart conduction disorders (AIR 3.25; 95%CI 2.45 to 4.30; р<0.05). At the same time the age-adjusted frequency of ischemic heart disease (AIR 1.12; 95%CI 0.9-1.39; р>0.05) and atrial fibrillation (AIR 0.94; 95%CI 0.52-1.56; р>0.05) was not significantly different in patients with and without MAC. Multivariate analysis adjusted for age and total cholesterol level obtained significant associations of MAC presence with symptomatic atherosclerotic peripheral arterial disease (p <0.001; ß=0.410). The frequency of stroke in patients with and without MAC did not differ (p>0.05). In the group of patients with MAC as compared to patients without MAC echocardiographic evaluation showed higher incidence of mitral regurgitation (AIR 1.51; 95%CI 1.21-1.82; p<0.05), left atrium increased size (AIR 1.68; 95%CI 1.27-2.23; p<0.05), concentric left ventricular hypertrophy (AIR 2.15; 95%CI 1.67-2.75; p<0.05), mitral valve thickening (100.0% vs 30.7%, p <0.001), aortic valve calcification (49% vs 0%, p <0.001), aortic regurgitation 1-2 degree (67.0% vs 13.9%, p <0.001). Conclusion. The study revealed some echocardiographic and clinical features associated with the MAC in elderly patients.

About the Authors

N. S. Chipigina
Russian National Research Medical University named after NI Pirogov
Russian Federation


G. M. Urvacheva
Center of Diagnostic and Rehabilitation, Branch of “Gazprom Transgaz Moscow"
Russian Federation


N. A. Shostak
Russian National Research Medical University named after NI Pirogov
Russian Federation


I. V. Zhitareva
Russian National Research Medical University named after NI Pirogov
Russian Federation


I. Yu. Zhitomirskaya
Municipal outpatient clinic N141
Russian Federation


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For citation:


Chipigina N.S., Urvacheva G.M., Shostak N.A., Zhitareva I.V., Zhitomirskaya I.Yu. MITRAL ANNULAR CALCIFICATION IN ELDERLY PATIENTS. CLINICAL AND ECHOCARDIOGRAPHIC CHARACTERISTICS. Rational Pharmacotherapy in Cardiology. 2011;7(6):690-697. (In Russ.) https://doi.org/10.20996/1819-6446-2011-7-6-690-697

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