Mitral Annulus Calcium Score in Patients With Calcific Mitral Stenosis Undergoing Invasive Hemodynamic Assessment

Author:

El Sabbagh Abdallah1ORCID,Parikh Pragnesh1ORCID,Ray Jordan1,Nishimura Rick A.2ORCID,Pislaru Sorin V.2ORCID,Pellikka Patricia A.2ORCID,Guerrero Mayra2ORCID,Hochwald Alexander3ORCID,Miranda William R.2ORCID

Affiliation:

1. Department of Cardiovascular Diseases Mayo Clinic Jacksonville FL

2. Department of Cardiovascular Diseases Mayo Clinic Rochester MN

3. Department of Health Science Research Mayo Clinic Jacksonville FL

Abstract

Background Aortic valve calcium score is associated with hemodynamic severity of aortic stenosis. Whether this association is present in calcific mitral stenosis remains unknown. Methods and Results This study was a retrospective analysis of consecutive patients with mitral stenosis secondary to mitral annular calcification (MAC) undergoing transseptal catheterization. All patients underwent invasive mitral valve assessment via direct left atrial and left ventricular pressure measurement. Computed tomography within 1 year of cardiac catheterization and with adequate visualization of the mitral annulus was included. MAC calcium score quantification by Agatston method was obtained offline using dedicated software (Aquarius, TeraRecon, V.4). Median patient age was 66.9±11.2 years, 47% of patients were women, 50% had coronary artery disease, 40% had atrial fibrillation, 47% had prior cardiac surgery, and 33% had prior chest radiation. Median diastolic mitral valve gradient was 9.4±3.4 mm Hg on echocardiography and 8.5±4 mm Hg invasively. Invasive median mitral valve area using the Gorlin formula was 1.87±0.9 cm 2 . Median MAC calcium score for the cohort was 7280±7937 Hounsfield units. MAC calcium score correlated with the presence of atrial fibrillation ( P =0.02) but was not associated with other comorbidities. There was no correlation between MAC calcium score and mitral valve area ( r =0.07; P =0.6) or mitral valve gradient ( r =−0.03; P =0.8). Conclusions MAC calcium score did not correlate with invasively measured mitral valve gradient and mitral valve area in patients with MAC‐related mitral stenosis, suggesting that calcium score should not be used as a surrogate for invasive hemodynamic parameters.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Cardiology and Cardiovascular Medicine

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