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Published online: 2021-07-07
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Association between mitral annulus calcification and subtypes of heart failure rehospitalization

Yuta Kato, Tadaaki Arimura, Yuhei Shiga, Takashi Kuwano, Makoto Sugihara, Shin-ichiro Miura
DOI: 10.5603/CJ.a2021.0076
·
Pubmed: 34240401

open access

Ahead of print
Original articles
Published online: 2021-07-07

Abstract

Background: Mitral annulus calcification (MAC) has been associated with cardiovascular diseases, including heart failure (HF); however, the associations between MAC and both the category and etiology of HF have not been fully elucidated. The aim of this study was to investigate the relationship between MAC and three types of HF rehospitalization: HF with preserved ejection fraction (HFpEF), HF with mid-range EF (HFmrEF), and HF with reduced EF (HFrEF).

Methods: We enrolled consecutive patients undergoing echocardiography, who were admitted to our hospital for clinically indicated congestive HF between April 2014 and March 2018. Cox proportional-hazards models were used after adjusting for age, gender, and hypertension.

Results: Of 353 patients, 40 (11.3%) had MAC. With a median follow-up of 2.8 years, 100 (28%) patients were rehospitalized for congestive HF (HFpEF 40%, HFmrEF 16%, HFrEF 44%, respectively). According to the Kaplan-Meier method, the estimated incidence of HFpEF rehospitalization in the MAC group was significantly greater than that in the non-MAC group (p < 0.001) whereas the incidences of HFmrEF and HFrEF rehospitalization were comparable between the groups (p = 0.101 and p = .291, respectively). In a multivariate analysis, MAC remained significantly associated with HFpEF rehospitalization (hazard ratio: 3.379; 95% confidence interval: 1.651–6.597). At initial HF hospitalization, E/e’ was significantly higher in the MAC group (both septum and lateral, p < 0.05), suggesting a possible relationship between MAC and left ventricular diastolic function.

Conclusions: Mitral annulus calcification was associated with increased HFpEF rehospitalization and might be a cause of left ventricular diastolic dysfunction.

Abstract

Background: Mitral annulus calcification (MAC) has been associated with cardiovascular diseases, including heart failure (HF); however, the associations between MAC and both the category and etiology of HF have not been fully elucidated. The aim of this study was to investigate the relationship between MAC and three types of HF rehospitalization: HF with preserved ejection fraction (HFpEF), HF with mid-range EF (HFmrEF), and HF with reduced EF (HFrEF).

Methods: We enrolled consecutive patients undergoing echocardiography, who were admitted to our hospital for clinically indicated congestive HF between April 2014 and March 2018. Cox proportional-hazards models were used after adjusting for age, gender, and hypertension.

Results: Of 353 patients, 40 (11.3%) had MAC. With a median follow-up of 2.8 years, 100 (28%) patients were rehospitalized for congestive HF (HFpEF 40%, HFmrEF 16%, HFrEF 44%, respectively). According to the Kaplan-Meier method, the estimated incidence of HFpEF rehospitalization in the MAC group was significantly greater than that in the non-MAC group (p < 0.001) whereas the incidences of HFmrEF and HFrEF rehospitalization were comparable between the groups (p = 0.101 and p = .291, respectively). In a multivariate analysis, MAC remained significantly associated with HFpEF rehospitalization (hazard ratio: 3.379; 95% confidence interval: 1.651–6.597). At initial HF hospitalization, E/e’ was significantly higher in the MAC group (both septum and lateral, p < 0.05), suggesting a possible relationship between MAC and left ventricular diastolic function.

Conclusions: Mitral annulus calcification was associated with increased HFpEF rehospitalization and might be a cause of left ventricular diastolic dysfunction.

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Keywords

mitral annulus calcification, heart failure, heart failure with preserved ejection fraction

About this article
Title

Association between mitral annulus calcification and subtypes of heart failure rehospitalization

Journal

Cardiology Journal

Issue

Ahead of print

Article type

Original Article

Published online

2021-07-07

DOI

10.5603/CJ.a2021.0076

Pubmed

34240401

Keywords

mitral annulus calcification
heart failure
heart failure with preserved ejection fraction

Authors

Yuta Kato
Tadaaki Arimura
Yuhei Shiga
Takashi Kuwano
Makoto Sugihara
Shin-ichiro Miura

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