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Mitral annular calcification

MedGen UID:
331909
Concept ID:
C1835130
Finding
Synonym: Premature calcification of mitral annulus
 
HPO: HP:0005136

Definition

Mitral annular calcification (MAC) results from progressive calcium deposition along and beneath the mitral valve annulus. [from HPO]

Term Hierarchy

Conditions with this feature

Marfan syndrome
MedGen UID:
44287
Concept ID:
C0024796
Disease or Syndrome
FBN1-related Marfan syndrome (Marfan syndrome), a systemic disorder of connective tissue with a high degree of clinical variability, comprises a broad phenotypic continuum ranging from mild (features of Marfan syndrome in one or a few systems) to severe and rapidly progressive neonatal multiorgan disease. Cardinal manifestations involve the ocular, skeletal, and cardiovascular systems. Ocular findings include myopia (>50% of affected individuals); ectopia lentis (seen in approximately 60% of affected individuals); and an increased risk for retinal detachment, glaucoma, and early cataracts. Skeletal system manifestations include bone overgrowth and joint laxity; disproportionately long extremities for the size of the trunk (dolichostenomelia); overgrowth of the ribs that can push the sternum in (pectus excavatum) or out (pectus carinatum); and scoliosis that ranges from mild to severe and progressive. The major morbidity and early mortality in Marfan syndrome relate to the cardiovascular system and include dilatation of the aorta at the level of the sinuses of Valsalva (predisposing to aortic tear and rupture), mitral valve prolapse with or without regurgitation, tricuspid valve prolapse, and enlargement of the proximal pulmonary artery. Severe and prolonged regurgitation of the mitral and/or aortic valve can predispose to left ventricular dysfunction and occasionally heart failure. With proper management, the life expectancy of someone with Marfan syndrome approximates that of the general population.

Professional guidelines

PubMed

Guerrero ME, Grayburn P, Smith RL 2nd, Sorajja P, Wang DD, Ahmad Y, Blusztein D, Cavalcante J, Tang GHL, Ailawadi G, Lim DS, Blanke P, Eleid MF, Kaneko T, Thourani VH, Bapat V, Mack MJ, Leon MB, George I
JACC Cardiovasc Interv 2023 Sep 25;16(18):2195-2210. doi: 10.1016/j.jcin.2023.06.044. PMID: 37758378
El-Eshmawi A, Alexis SL, Sengupta A, Pandis D, Rimsukcharoenchai C, Adams DH, Tang GHL
Curr Opin Cardiol 2020 Mar;35(2):107-115. doi: 10.1097/HCO.0000000000000718. PMID: 31895243
Al-Taweel A, Almahmoud MF, Khairandish Y, Ahmad M
Echocardiography 2019 Oct;36(10):1901-1909. Epub 2019 Oct 6 doi: 10.1111/echo.14495. PMID: 31587368

Recent clinical studies

Etiology

Guerrero ME, Eleid MF, Wang DD, Pursnani A, Kodali SK, George I, Palacios I, Russell H, Makkar RR, Kar S, Satler LF, Rajagopal V, Dangas G, Tang GHL, McCabe JM, Whisenant BK, Fang K, Balan P, Smalling R, Kaptzan T, Lewis B, Douglas PS, Hahn RT, Thaden J, Oh JK, Leon M, O'Neill W, Rihal C
JACC Cardiovasc Interv 2023 Sep 25;16(18):2211-2227. doi: 10.1016/j.jcin.2023.06.041. PMID: 37758379
Guerrero ME, Grayburn P, Smith RL 2nd, Sorajja P, Wang DD, Ahmad Y, Blusztein D, Cavalcante J, Tang GHL, Ailawadi G, Lim DS, Blanke P, Eleid MF, Kaneko T, Thourani VH, Bapat V, Mack MJ, Leon MB, George I
JACC Cardiovasc Interv 2023 Sep 25;16(18):2195-2210. doi: 10.1016/j.jcin.2023.06.044. PMID: 37758378
Qamar F, Attar RH, Nabi F
Methodist Debakey Cardiovasc J 2022;18(1):7-9. Epub 2022 Apr 1 doi: 10.14797/mdcvj.1096. PMID: 35432730Free PMC Article
Kassar M, Khalique OK, Pilgrim T, Reineke D, Carrel T, Windecker S, George I, Praz F
Interv Cardiol Clin 2019 Jul;8(3):313-319. Epub 2019 Apr 8 doi: 10.1016/j.iccl.2019.02.006. PMID: 31078187
Abramowitz Y, Jilaihawi H, Chakravarty T, Mack MJ, Makkar RR
J Am Coll Cardiol 2015 Oct 27;66(17):1934-41. doi: 10.1016/j.jacc.2015.08.872. PMID: 26493666

Diagnosis

Guerrero ME, Grayburn P, Smith RL 2nd, Sorajja P, Wang DD, Ahmad Y, Blusztein D, Cavalcante J, Tang GHL, Ailawadi G, Lim DS, Blanke P, Eleid MF, Kaneko T, Thourani VH, Bapat V, Mack MJ, Leon MB, George I
JACC Cardiovasc Interv 2023 Sep 25;16(18):2195-2210. doi: 10.1016/j.jcin.2023.06.044. PMID: 37758378
Hu PT, Xu B, Grimm RA, Unai S, Miyasaka RL
Circ Cardiovasc Imaging 2020 Nov;13(11):e010541. Epub 2020 Nov 11 doi: 10.1161/CIRCIMAGING.120.010541. PMID: 33172308
Scotti A, Massussi M, Baritussio A, Pergola V
Eur Heart J 2020 Aug 1;41(29):2817. doi: 10.1093/eurheartj/ehaa223. PMID: 32285092
Reddy YNV, Murgo JP, Nishimura RA
Circulation 2019 Aug 13;140(7):523-525. Epub 2019 Aug 12 doi: 10.1161/CIRCULATIONAHA.119.040095. PMID: 31403845
Abramowitz Y, Jilaihawi H, Chakravarty T, Mack MJ, Makkar RR
J Am Coll Cardiol 2015 Oct 27;66(17):1934-41. doi: 10.1016/j.jacc.2015.08.872. PMID: 26493666

Therapy

Scotti A, Ho EC, Echarte-Morales J, Sturla M, Chau M, Joseph CA, Slipczuk L, Ranard L, Vahl TP, Granada JF, Latib A
JACC Cardiovasc Interv 2024 Mar 11;17(5):699-701. doi: 10.1016/j.jcin.2024.01.011. PMID: 38479970
Guerrero ME, Grayburn P, Smith RL 2nd, Sorajja P, Wang DD, Ahmad Y, Blusztein D, Cavalcante J, Tang GHL, Ailawadi G, Lim DS, Blanke P, Eleid MF, Kaneko T, Thourani VH, Bapat V, Mack MJ, Leon MB, George I
JACC Cardiovasc Interv 2023 Sep 25;16(18):2195-2210. doi: 10.1016/j.jcin.2023.06.044. PMID: 37758378
Qamar F, Attar RH, Nabi F
Methodist Debakey Cardiovasc J 2022;18(1):7-9. Epub 2022 Apr 1 doi: 10.14797/mdcvj.1096. PMID: 35432730Free PMC Article
Demir OM, Ruparelia N, Gopalan D, Busi G, Frame A, Sutaria N, Ariff B, Sen S, Malik I, Colombo A, Mikhail GW
Cardiovasc Revasc Med 2019 Mar;20(3):194-196. Epub 2018 Apr 7 doi: 10.1016/j.carrev.2018.03.022. PMID: 29681536
Urena M, Himbert D, Brochet E, Carrasco JL, Iung B, Nataf P, Vahanian A
JACC Cardiovasc Interv 2017 Oct 9;10(19):1905-1919. doi: 10.1016/j.jcin.2017.06.069. PMID: 28982555

Prognosis

Patlolla SH, Schaff HV, Nishimura RA, Geske JB, Lahr BD, Lee AT, Eleid MF, Ommen SR, Dearani JA
Ann Thorac Surg 2022 Nov;114(5):1679-1687. Epub 2021 Nov 22 doi: 10.1016/j.athoracsur.2021.09.077. PMID: 34822847
Hu PT, Xu B, Grimm RA, Unai S, Miyasaka RL
Circ Cardiovasc Imaging 2020 Nov;13(11):e010541. Epub 2020 Nov 11 doi: 10.1161/CIRCIMAGING.120.010541. PMID: 33172308
Massera D, Kizer JR, Dweck MR
Trends Cardiovasc Med 2020 Jul;30(5):289-295. Epub 2019 Aug 5 doi: 10.1016/j.tcm.2019.07.011. PMID: 31402089
Barker CM, Reardon MJ
Future Cardiol 2018 Sep;14(5):367-373. Epub 2018 Aug 24 doi: 10.2217/fca-2018-0044. PMID: 30141342
Lyle MA, Snipelisky DF, Aggarwal NR, Miller FA, Anavekar NS
Int J Cardiovasc Imaging 2017 May;33(5):615-621. Epub 2016 Dec 22 doi: 10.1007/s10554-016-1043-5. PMID: 28004210

Clinical prediction guides

Guerrero ME, Eleid MF, Wang DD, Pursnani A, Kodali SK, George I, Palacios I, Russell H, Makkar RR, Kar S, Satler LF, Rajagopal V, Dangas G, Tang GHL, McCabe JM, Whisenant BK, Fang K, Balan P, Smalling R, Kaptzan T, Lewis B, Douglas PS, Hahn RT, Thaden J, Oh JK, Leon M, O'Neill W, Rihal C
JACC Cardiovasc Interv 2023 Sep 25;16(18):2211-2227. doi: 10.1016/j.jcin.2023.06.041. PMID: 37758379
Patlolla SH, Schaff HV, Nishimura RA, Geske JB, Lahr BD, Lee AT, Eleid MF, Ommen SR, Dearani JA
Ann Thorac Surg 2022 Nov;114(5):1679-1687. Epub 2021 Nov 22 doi: 10.1016/j.athoracsur.2021.09.077. PMID: 34822847
Hu PT, Xu B, Grimm RA, Unai S, Miyasaka RL
Circ Cardiovasc Imaging 2020 Nov;13(11):e010541. Epub 2020 Nov 11 doi: 10.1161/CIRCIMAGING.120.010541. PMID: 33172308
Lyle MA, Snipelisky DF, Aggarwal NR, Miller FA, Anavekar NS
Int J Cardiovasc Imaging 2017 May;33(5):615-621. Epub 2016 Dec 22 doi: 10.1007/s10554-016-1043-5. PMID: 28004210
Eleid MF, Foley TA, Said SM, Pislaru SV, Rihal CS
JACC Cardiovasc Imaging 2016 Nov;9(11):1318-1337. doi: 10.1016/j.jcmg.2016.09.001. PMID: 27832900

Recent systematic reviews

Moin A, Lak HM, Zafar M, Tariq R, Shaikh FH, Mussa M, Bansal A, Shekhar S, Harb S, Unai S, Kapadia SR
Am J Cardiol 2023 Aug 15;201:123-130. Epub 2023 Jun 27 doi: 10.1016/j.amjcard.2023.05.069. PMID: 37385163
Kumar A, Samra G, Kaur S, Ogunnowo G, Kocyigit D, Xu B
Curr Probl Cardiol 2023 Mar;48(3):101558. Epub 2022 Dec 18 doi: 10.1016/j.cpcardiol.2022.101558. PMID: 36538998
Alexis SL, Malik AH, El-Eshmawi A, George I, Sengupta A, Kodali SK, Hahn RT, Khalique OK, Zaid S, Guerrero M, Bapat VN, Leon MB, Adams DH, Tang GHL
J Am Heart Assoc 2021 Apr 6;10(7):e018514. Epub 2021 Mar 17 doi: 10.1161/JAHA.120.018514. PMID: 33728929Free PMC Article
Ben-Ali W, Ibrahim R, Rodès-Cabeau J, von Bardeleben RS, Mylotte D, Granada J, Modine T
Curr Cardiol Rep 2021 Mar 9;23(4):37. doi: 10.1007/s11886-021-01466-7. PMID: 33687594
Puri R, Abdul-Jawad Altisent O, del Trigo M, Campelo-Parada F, Regueiro A, Barbosa Ribeiro H, DeLarochellière R, Paradis JM, Dumont E, Rodés-Cabau J
Catheter Cardiovasc Interv 2016 Feb 15;87(3):540-8. Epub 2015 Nov 18 doi: 10.1002/ccd.26262. PMID: 26577250

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