title: Mitral annular calcification as a marker of complex aortic atheroma in patients with stroke of uncertain etiology.
abstract: The aim of this study was to evaluate the presence of dense mitral annular calcification as a marker of complex aortic atherosclerosis in patients with stroke of uncertain etiology. One hundred twenty-one patients with stroke of uncertain etiology were evaluated for complex aortic atherosclerotic plaques; their presence and severity were correlated with transthoracic echocardiographic findings, demographic data, and cardiovascular risk factors. Complex plaques in the ascending aorta or aortic arch were found in 72 of the 121 patients (59.5%). The only difference seen in patients with or without plaques was the presence of dense mitral annular calcification (58.3 vs 16.3%; P < 0.001). Dense mitral annular calcification (n = 50) was associated with higher prevalence of complex aortic plaques (84.0% vs 42.3%; P < 0.001), mobile components (28.0% vs 9.9%; P < 0.01), and protruding (80.0% vs 36.6%; P < 0.001), ulcerated (16.0% vs 1.4%; P < 0.01), and multisite complex plaques (46.0% vs 9.0%; P < 0.001). Therefore, in patients with stroke of uncertain etiology dense mitral annular calcification is an important marker of aortic atherosclerosis with high risk of embolism, and this association may explain in part the high prevalence of stroke and peripheral embolism in patients with mitral annular calcification.
authors.affiliation: Department of Cardiology, Hospital Universitari del Sagrat Cor, Viladomat, Barcelona, Spain.
authors.forename: Ramón
authors.initials: R
authors.lastname: Pujadas
authors.forename: Adrià
authors.initials: A
authors.lastname: Arboix
authors.forename: Núria
authors.initials: N
authors.lastname: Anguera
authors.forename: Josefa
authors.initials: J
authors.lastname: Rafel
authors.forename: Federico
authors.initials: F
authors.lastname: Sagués
authors.forename: Roser
authors.initials: R
authors.lastname: Casañas
mesh_terms: D000368:Aged; D001018:Aortic Diseases / Q000150:complications / Q000000981:diagnostic imaging* / Q000453:epidemiology; D050197:Atherosclerosis / Q000150:complications / Q000000981:diagnostic imaging* / Q000453:epidemiology; D002114:Calcinosis / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000473:pathology; D016009:Chi-Square Distribution; D004452:Echocardiography; D005260:Female; D006801:Humans; D008297:Male; D008943:Mitral Valve / Q000000981:diagnostic imaging* / Q000473:pathology; D015995:Prevalence; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology / Q000209:etiology*