title: Assessment of left atrial volume and mechanical functions using real-time three-dimensional echocardiography in patients with mitral annular calcification.
abstract: OBJECTIVE
  Mitral annular calcification (MAC) is degeneration of the fibrous annular ring of the mitral valve. Left atrial (LA) function and volume have been evaluated by many methods; however, none have used real-time three-dimensional echocardiography (RT3DE) in patients with MAC. Our study is the first to evaluate LA volume and mechanical function using RT3DE in patients with MAC.
  
  
  METHODS
  Our study was a prospective cross-sectional study. In total, 32 patients with echocardiographic evidence of MAC and 30 volunteers without MAC were enrolled in the study. Kolmogorov-Smirnov test, Student's t-test, Mann-Whitney U test, chi-square test, Pearson's correlation test, and multiple linear regression analyses were used in this study.
  
  
  RESULTS
  LA diameter was significantly higher in patients with MAC (38.5±3.8 vs. 31.1±2.9, p<0.001). Maximum LA volume (49.6±11.2 vs. 35.6±2.5, p<0.001), minimum LA volume (23.8±7.9 vs. 12.6±2.3, p<0.001), and LA volume index (LAVI) (26.9±6.1 vs. 20.5±2.4, p<0.001) were also higher in the MAC group. LAVI was correlated with age (p<0.001), blood urea nitrogen levels (p=0.089), total cholesterol levels (p=0.055), left ventricular systolic myocardial velocity (p=0.048), E/A ratio (p<0.001), and MAC (p<0.001). Multiple linear regression analyses revealed that age (β=0.390, p<0.001) and MAC (β=0.527, p<0.001) were independent predictors of LAVI.
  
  
  CONCLUSIONS
  We found that LA mechanical function was impaired in patients with MAC. Furthermore, age and MAC were independent predictors of increased LAVI according to our RT3DE examination.
authors.affiliation: Department of Cardiology, Elbistan State Hospital; Kahramanmaraş-Turkey. hakantasolar@gmail.com.
authors.forename: Adil
authors.initials: A
authors.lastname: Bayramoğlu
authors.forename: Hakan
authors.initials: H
authors.lastname: Taşolar
authors.forename: Yılmaz Ömür
authors.initials: YÖ
authors.lastname: Otlu
authors.forename: Şıho
authors.initials: Ş
authors.lastname: Hidayet
authors.forename: Fuat
authors.initials: F
authors.lastname: Kurt
authors.forename: Adil
authors.initials: A
authors.lastname: Doğan
authors.forename: Hasan
authors.initials: H
authors.lastname: Pekdemir
mesh_terms: D016279:Atrial Function, Left; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D019560:Echocardiography, Three-Dimensional; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D008946:Mitral Valve Stenosis / Q000000981:diagnostic imaging*; D011446:Prospective Studies; D012720:Severity of Illness Index