Sex Differences in Mitral Annular Calcification and the Clinical Implications
Background: Heterogeneous mechanisms may contribute to the occurrence of mitral annular calcification (MAC), however, little is known about the sex differences in MAC and the clinical implications of these differences. This study aimed to investigate clinical and imaging differences of MAC according...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2021-10-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2021.736040/full |
| _version_ | 1818732102902874112 |
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| author | Jiwon Seo Hyeonju Jeong Iksung Cho Geu-Ru Hong Jong-Won Ha Chi Young Shim |
| author_facet | Jiwon Seo Hyeonju Jeong Iksung Cho Geu-Ru Hong Jong-Won Ha Chi Young Shim |
| author_sort | Jiwon Seo |
| collection | DOAJ |
| description | Background: Heterogeneous mechanisms may contribute to the occurrence of mitral annular calcification (MAC), however, little is known about the sex differences in MAC and the clinical implications of these differences. This study aimed to investigate clinical and imaging differences of MAC according to sex.Methods: In total, 537 patients (221 men) with MAC were identified by transthoracic echocardiography at a single center from January 2012 to June 2016. Moderate-to-severe MAC was defined as calcification extent ≥120° of the mitral annulus. Significant functional mitral stenosis (MS) was defined as a transmitral mean diastolic pressure gradient ≥5 mmHg.Results: Women more frequently had moderate-to-severe MAC and concomitant mitral regurgitation than men; however, significant functional MS was comparable between sexes. In the logistic regression analysis, old age, uncontrolled hypertension, end-stage renal disease (ESRD), and obstructive hypertrophic cardiomyopathy were significantly associated with moderate-to-severe MAC in women, whereas ESRD and moderate-to-severe aortic stenosis were in men. In the Cox regression analysis, significant functional MS was associated with all-cause death in both sexes, although an independent association was found in only women.Conclusion: Women had more extended MAC than men. Significant functional MS was independently associated with unfavorable clinical outcomes in patients with MAC, which was more pronounced in women than in men. |
| first_indexed | 2024-12-17T23:28:14Z |
| format | Article |
| id | doaj.art-df79b0ba8af4416cb395d25e11e435df |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-12-17T23:28:14Z |
| publishDate | 2021-10-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-df79b0ba8af4416cb395d25e11e435df2022-12-21T21:28:43ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2021-10-01810.3389/fcvm.2021.736040736040Sex Differences in Mitral Annular Calcification and the Clinical ImplicationsJiwon Seo0Hyeonju Jeong1Iksung Cho2Geu-Ru Hong3Jong-Won Ha4Chi Young Shim5Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, South KoreaDivision of Cardiology, Department of Internal Medicine, Myongji Hospital, Hanyang University Medical Center, Seoul, South KoreaDivision of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, South KoreaDivision of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, South KoreaDivision of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, South KoreaDivision of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, South KoreaBackground: Heterogeneous mechanisms may contribute to the occurrence of mitral annular calcification (MAC), however, little is known about the sex differences in MAC and the clinical implications of these differences. This study aimed to investigate clinical and imaging differences of MAC according to sex.Methods: In total, 537 patients (221 men) with MAC were identified by transthoracic echocardiography at a single center from January 2012 to June 2016. Moderate-to-severe MAC was defined as calcification extent ≥120° of the mitral annulus. Significant functional mitral stenosis (MS) was defined as a transmitral mean diastolic pressure gradient ≥5 mmHg.Results: Women more frequently had moderate-to-severe MAC and concomitant mitral regurgitation than men; however, significant functional MS was comparable between sexes. In the logistic regression analysis, old age, uncontrolled hypertension, end-stage renal disease (ESRD), and obstructive hypertrophic cardiomyopathy were significantly associated with moderate-to-severe MAC in women, whereas ESRD and moderate-to-severe aortic stenosis were in men. In the Cox regression analysis, significant functional MS was associated with all-cause death in both sexes, although an independent association was found in only women.Conclusion: Women had more extended MAC than men. Significant functional MS was independently associated with unfavorable clinical outcomes in patients with MAC, which was more pronounced in women than in men.https://www.frontiersin.org/articles/10.3389/fcvm.2021.736040/fullmitral annular calcification (MAC)sexechocardiographymitral stenosis (MS)mitral valve (MV) |
| spellingShingle | Jiwon Seo Hyeonju Jeong Iksung Cho Geu-Ru Hong Jong-Won Ha Chi Young Shim Sex Differences in Mitral Annular Calcification and the Clinical Implications Frontiers in Cardiovascular Medicine mitral annular calcification (MAC) sex echocardiography mitral stenosis (MS) mitral valve (MV) |
| title | Sex Differences in Mitral Annular Calcification and the Clinical Implications |
| title_full | Sex Differences in Mitral Annular Calcification and the Clinical Implications |
| title_fullStr | Sex Differences in Mitral Annular Calcification and the Clinical Implications |
| title_full_unstemmed | Sex Differences in Mitral Annular Calcification and the Clinical Implications |
| title_short | Sex Differences in Mitral Annular Calcification and the Clinical Implications |
| title_sort | sex differences in mitral annular calcification and the clinical implications |
| topic | mitral annular calcification (MAC) sex echocardiography mitral stenosis (MS) mitral valve (MV) |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2021.736040/full |
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