title: Association of Mitral Annular Calcification with Left Ventricular Mechanics: A Speckle Tracking Study.
abstract: BACKGROUND
  Mitral annular calcification (MAC) is a common echocardiographic finding in clinical practice and is associated with cardiovascular risk factors and atherosclerosis. However, data regarding left ventricular (LV) functions are lacking. We aimed to evaluate the relationship between MAC and LV mechanical functions with the utility of two-dimensional speckle tracking echocardiography (2DSTE).
  
  
  METHODS
  The study involved 91 patients with MAC and 48 control subjects. Mitral annular thickness of 1-2 mm was reported as mild, 2-5 mm as moderate, and >5 mm as severe MAC. All patients underwent 2D echocardiography.
  
  
  RESULTS
  MAC was observed in 91 (65.5%) patients. Of LV diastolic parameters, E/Em ratio, LAVI, LV mass index, and t-LV UR were increased. Of LV systolic parameters, GLS and Sm were decreased, whereas Ar, Ar-rate systole, peak LV twist, peak LV twist rate, LV-tor, and MPI were increased, which were all correlated with presence and severity of MAC. Multivariate linear regression analysis showed that LV mass index (β = 0.225, P = 0.012), t-LV UR (β = 0.370, P < 0.001), LV mass index (β = 0.183, P = 0.025), MPI (β = 0.288, P < 0.001), and GLS (β = -0.385, P < 0.001) were significantly associated with MAC severity.
  
  
  CONCLUSIONS
  The presence and severity of MAC is associated with impaired LV systolic and diastolic functions. Therefore, preventive strategies might be taken in patients with MAC to avoid LV systolic and diastolic dysfunction.
authors.affiliation: Department of Cardiology, Medical School, Kafkas University, Kars, Turkey.
authors.forename: Tayyar
authors.initials: T
authors.lastname: Gökdeniz
authors.affiliation: Department of Cardiology, Ahi Evren Chest and Cardiovascular Surgery Education and Research Hospital, Trabzon, Turkey.
authors.forename: Faruk
authors.initials: F
authors.lastname: Boyaci
authors.affiliation: Department of Cardiology, Ahi Evren Chest and Cardiovascular Surgery Education and Research Hospital, Trabzon, Turkey.
authors.forename: Engin
authors.initials: E
authors.lastname: Hatem
authors.affiliation: Department of Cardiology, Ahi Evren Chest and Cardiovascular Surgery Education and Research Hospital, Trabzon, Turkey.
authors.forename: Hüseyin
authors.initials: H
authors.lastname: Bektaş
authors.affiliation: Department of Cardiology, Ahi Evren Chest and Cardiovascular Surgery Education and Research Hospital, Trabzon, Turkey.
authors.forename: Ezgi
authors.initials: E
authors.lastname: Kalaycıoğlu
authors.affiliation: Department of Cardiology, Gaziemir Salih Nevvar İşgören State Hospital, İzmir, Turkey.
authors.forename: Mustafa Ozan
authors.initials: MO
authors.lastname: Gürsoy
authors.affiliation: Department of Cardiology, Ahi Evren Chest and Cardiovascular Surgery Education and Research Hospital, Trabzon, Turkey.
authors.forename: Ahmet Çağrı
authors.initials: AÇ
authors.lastname: Aykan
authors.affiliation: Department of Internal Medicine, Dr Lutfu Kırdar Kartal Educational and Research Hospital, İstanbul, Turkey.
authors.forename: Banu Şahin
authors.initials: BŞ
authors.lastname: Yıldız
authors.affiliation: Department of Cardiology, Diyarbakır Education and Research Hospital, Diyarbakır, Turkey.
authors.forename: Bernas
authors.initials: B
authors.lastname: Altıntaş
mesh_terms: D000368:Aged; D002114:Calcinosis / Q000150:complications* / Q000000981:diagnostic imaging*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008943:Mitral Valve / Q000000981:diagnostic imaging*; D011446:Prospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D014463:Ultrasonography; D018487:Ventricular Dysfunction, Left / Q000150:complications* / Q000000981:diagnostic imaging*
keywords: left ventricular mechanical functions; mitral annular calcification; subclinical left ventricle systolic dysfunction; two-dimensional speckle tracking echocardiography