title: Association Between Mitral Annular Calcium and Flail Mitral Leaflet in Degenerative Mitral Valve Disease.
abstract: The aim of this study was to assess the association between mitral annular calcium (MAC) and flail mitral leaflets in a cohort of patients with degenerative mitral valve disease. A retrospective study was conducted of consecutive patients with degenerative mitral valve disease who underwent echocardiography at Rabin Medical Center from 2003 to 2012. Special focus was attended to the presence and grade of MAC and characterization of valve pathology (myxomatous vs nonmyxomatous, prolapse vs flail). Patients were excluded if they had undergone previous mitral valve surgery and/or had infective endocarditis. Multivariate logistic regressions were used to control for confounders. The study included 1,912 patients (60.8% men, mean age 63.8 ± 17.4 years) divided into 3 groups: 1,627 (86%) without MAC, 183 (10%) with either mild or moderate MAC, and 94 (5%) with severe MAC. The presence of flail leaflet was 27%, 30%, and 46% in these groups, respectively (p <0.001). After adjustment for age, gender, and co-morbidities, the odd ratio for flail mitral leaflet with severe MAC versus no MAC was 1.76 (95% confidence interval 1.10 to 2.83, p = 0.019). In conclusion, this study demonstrates that degenerative mitral valve disease with severe MAC is significantly associated with flail mitral leaflet.
authors.affiliation: The Echocardiography Unit and Valvular Clinic, Department of Cardiology, Rabin Medical Center, Beilinson Hospital, Petach-Tikva and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. Electronic address: noaz@clalit.org.il.
authors.forename: Noa
authors.initials: N
authors.lastname: Zemer Wassercug
authors.affiliation: The Echocardiography Unit and Valvular Clinic, Department of Cardiology, Rabin Medical Center, Beilinson Hospital, Petach-Tikva and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Yaron
authors.initials: Y
authors.lastname: Shapira
authors.affiliation: The Echocardiography Unit and Valvular Clinic, Department of Cardiology, Rabin Medical Center, Beilinson Hospital, Petach-Tikva and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Daniel
authors.initials: D
authors.lastname: Weisenberg
authors.affiliation: The Echocardiography Unit and Valvular Clinic, Department of Cardiology, Rabin Medical Center, Beilinson Hospital, Petach-Tikva and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Daniel
authors.initials: D
authors.lastname: Monakier
authors.affiliation: The Echocardiography Unit and Valvular Clinic, Department of Cardiology, Rabin Medical Center, Beilinson Hospital, Petach-Tikva and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Tamir
authors.initials: T
authors.lastname: Bental
authors.affiliation: The Echocardiography Unit and Valvular Clinic, Department of Cardiology, Rabin Medical Center, Beilinson Hospital, Petach-Tikva and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Alik
authors.initials: A
authors.lastname: Sagie
authors.affiliation: The Echocardiography Unit and Valvular Clinic, Department of Cardiology, Rabin Medical Center, Beilinson Hospital, Petach-Tikva and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Mordehay
authors.initials: M
authors.lastname: Vaturi
mesh_terms: D000369:Aged, 80 and over; D002114:Calcinosis / Q000000981:diagnostic imaging* / Q000453:epidemiology; D017548:Echocardiography, Transesophageal; D005260:Female; D006349:Heart Valve Diseases / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000473:pathology*; D006801:Humans; D007557:Israel / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging* / Q000473:pathology*; D008945:Mitral Valve Prolapse / Q000000981:diagnostic imaging / Q000473:pathology; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index