Mitral annular calcification is associated with reduced left ventricular function and inflammation in patients with chronic kidney disease.
BACKGROUND
Mitral annular calcification (MAC) is prevalent in patients with chronic kidney disease (CKD); however, it is not known whether the increased cardiovascular risk observed in patients with CKD and MAC is related to atherosclerotic burden, because they share common risk factors.


METHODS
Transthoracic echocardiography was performed in patients with CKD undergoing pre-kidney transplantation evaluation. Fasting lipids, high-sensitivity C-reactive protein, parathyroid hormone, calcium, and creatinine levels were measured.


RESULTS
Of 99 participants, the 31 with MAC had higher carotid intima-media thickness (P = .004), lower left ventricular ejection fraction (P = .016), and higher high-sensitivity C-reactive protein (P = .01). MAC was predicted independently by increasing high-sensitivity C-reactive protein, decreasing left ventricular ejection fraction, and not being on dialysis (likelihood ratio 21.8, P < .001). Models were not affected significantly by the addition of age, carotid intima-media thickness, and other laboratory tests.


CONCLUSIONS
In patients with CKD, MAC is associated with inflammation, reduced left ventricular function, and treatment with dialysis, independent of the degree of subclinical atherosclerosis.
Rao
Anupama K
AK
University of Wisconsin School of Medicine and Public Health, Division of Cardiovascular Medicine and Section of Nephrology, Madison, Wisconsin 53792, USA.
Djamali
Arjang
A
Korcarz
Claudia E
CE
Aeschlimann
Susan E
SE
Wolff
Matthew R
MR
Stein
James H
JH
D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D002114:Calcinosis / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology; D002118:Calcium / Q000097:blood; D003404:Creatinine / Q000097:blood; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007249:Inflammation / Q000000981:diagnostic imaging / Q000209:etiology; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging* / Q000473:pathology*; D008946:Mitral Valve Stenosis / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology; D010281:Parathyroid Hormone / Q000097:blood; D015995:Prevalence; D011446:Prospective Studies; D006435:Renal Dialysis; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology; D012307:Risk Factors; D013318:Stroke Volume; D017539:Tunica Intima / Q000473:pathology; D017540:Tunica Media / Q000473:pathology; D014463:Ultrasonography; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000209:etiology / Q000473:pathology
D015415:Biomarkers; D010281:Parathyroid Hormone; D002097:C-Reactive Protein; D003404:Creatinine; D002118:Calcium