A Mitral Annular Calcification-Related Calcified Amorphous Tumor in End-Stage Renal Disease.
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ABSTRACT:
SUBMITTER: Sadeghpour A
PROVIDER: S-EPMC6058222 | biostudies-literature | 2017 Jun
REPOSITORIES: biostudies-literature
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A Mitral Annular Calcification-Related Calcified Amorphous Tumor in End-Stage Renal Disease.
Sadeghpour Anita A Alizadehasl Azin A Nojoomizadeh Leila L Pouraliakbar Hamidreza H Bayati Pravin P
CASE (Philadelphia, Pa.) 20170527 3
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Project description: Not available
| S-EPMC5827332 | biostudies-literature
Project description:BackgroundMitral annular calcium (MAC), commonly identified by cardiac imaging, is associated with cardiovascular events and predisposes to the development of clinically important mitral valve regurgitation and mitral valve stenosis. However, its biological determinants remain largely unknown.ObjectivesThe authors sought to evaluate whether a genetic predisposition to elevations in plasma lipids is associated with the presence of MAC.MethodsThe authors used 3 separate Mendelian randomization techniques to evaluate the associations of lipid genetic risk scores (GRS) with MAC in 3 large patient cohorts: the Framingham Health Study, MESA (Multiethnic European Study of Atherosclerosis), and the AGE-RS (Age, Gene/Environment Susceptibility-Reykjavik Study). The authors provided cross-ethnicity replication in the MESA Hispanic-American participants.ResultsMAC was present in 1,149 participants (20.4%). In pooled analyses across all 3 cohorts, a triglyceride GRS was significantly associated with the presence of MAC (odds ratio [OR] per triglyceride GRS unit: 1.73; 95% confidence interval [CI]: 1.24 to 2.41; p = 0.0013). Neither low- nor high-density lipoprotein cholesterol GRS was significantly associated with MAC. Results were consistent in cross-ethnicity analyses among the MESA Hispanic-Americans cohort (OR per triglyceride GRS unit: 2.04; 95% CI: 1.03 to 4.03; p = 0.04). In joint meta-analysis across all included cohorts, the triglyceride GRS was associated with MAC (OR per triglyceride GRS unit: 1.79; 95% CI: 1.32 to 2.41; p = 0.0001). The results were robust to several sensitivity analyses that limit both known and unknown forms of genetic pleiotropy.ConclusionsGenetic predisposition to elevated triglyceride levels was associated with the presence of MAC, a risk factor for clinically significant mitral valve disease, suggesting a causal association. Whether reducing triglyceride levels can lower the incidence of clinically significant mitral valve disease requires further study.
| S-EPMC5538134 | biostudies-literature
Project description:BackgroundMitral annular calcification (MAC) is associated with cardiovascular events and mitral valve dysfunction. However, the underlying pathophysiology remains incompletely understood. In this prospective longitudinal study, we used a multimodality approach including positron emission tomography, computed tomography, and echocardiography to investigate the pathophysiology of MAC and assess factors associated with disease activity and progression.MethodsA total of 104 patients (age 72±8 years, 30% women) with calcific aortic valve disease, therefore predisposed to MAC, underwent 18F-sodium fluoride (calcification activity) and 18F-Fluorodeoxyglucose (inflammation activity) positron emission tomography, computed tomography calcium scoring, and echocardiography. Sixty patients underwent repeat computed tomography and echocardiography after 2 years.ResultsMAC (mitral annular calcium score >0) was present in 35 (33.7%) patients who had increased 18F-fluoride (tissue-to-background ratio, 2.32 [95% CI, 1.81-3.27] versus 1.30 [1.22-1.49]; P<0.001) and 18F-Fluorodeoxyglucose activity (tissue-to-background ratio, 1.44 [1.37-1.58] versus 1.17 [1.12-1.24]; P<0.001) compared with patients without MAC. MAC activity (18F-fluoride uptake) was closely associated with the local calcium score and 18F-Fluorodeoxyglucose uptake, as well as female sex and renal function. Similarly, MAC progression was closely associated with local factors, in particular, baseline MAC. Traditional cardiovascular risk factors and calcification activity in bone or remote atherosclerotic areas were not associated with disease activity nor progression.ConclusionsMAC is characterized by increased local calcification activity and inflammation. Baseline MAC burden was associated with disease activity and the rate of subsequent progression. This suggests a self-perpetuating cycle of calcification and inflammation that may be the target of future therapeutic interventions.
| S-EPMC6366554 | biostudies-literature
Project description: Not available
| S-EPMC10241260 | biostudies-literature
Project description:A 67-year-old man was referred to our institution for the management of a left-sided intracardiac mass discovered following two cardioembolic events. Imaging studies revealed a highly mobile mass attached to the ventricular side of a calcified mitral annulus. The mass had not been present on echocardiography 1 year earlier. Surgical resection was performed. Microscopic examination confirmed the diagnosis of a calcified amorphous tumour. The postoperative course was unremarkable, and the patient remains asymptomatic and without recurrence of a mass or neurological event after a 12-month follow-up.
| S-EPMC4289819 | biostudies-literature
Project description:Mitral annular calcification (MAC) is a chronic degenerative process that implies calcification on the mitral support structure. It usually appears as a bystander to other cardiac pathologies hindering surgical treatment and increasing morbidity and mortality. When addressing the mitral valve, many surgical strategies have been suggested in the past with no clear consensus on what to choose. Moreover, and as transcatheter therapies have gained popularity over the last few decades, transcatheter mitral valve implantation has appeared as another alternative to conventional surgery. In this review, we aim at describing an overview of MAC, highlighting current challenges and treatment options as well as new potential alternatives.
| S-EPMC7525373 | biostudies-literature
Project description: Not available
| S-EPMC10750962 | biostudies-literature
Project description:BackgroundCalcified amorphous tumour (CAT) is a rare lesion that forms at various sites of the heart, including the mitral annulus. Since it is a systemic embolic source, it often requires resection. In contrast, caseous calcification of the mitral annulus (CCMA) usually receives conservative follow-up; however, it is sometimes resected to prevent embolism. Herein, we present a rare case of CCMA-associated CAT with chronic inflammatory cardiomyopathy and comprehensively consider the aetiology of CCMA-associated CAT.Case summaryA 52-year-old man with end-stage renal failure requiring haemodialysis underwent annual follow-up echocardiography for aortic valvular dysfunction. Echocardiography revealed a well-defined 22 × 17-mm circular mass on the annulus of the posterior mitral leaflet that had not been detected 2 years previously. Based on imaging characteristics, the mass was suspected to be a CCMA. It had rapidly enlarged and posed a potential risk for embolism; therefore, it was resected concurrently with aortic valve replacement. Although CCMA was suspected based on the intraoperative findings, the histopathological diagnosis was a CAT. Upon histological analysis of the left ventricular myocardial specimen and excised aortic valve, chronic inflammatory cell infiltration was observed; therefore, chronic inflammatory cardiomyopathy was diagnosed.DiscussionIn this case, the timing of decreased left ventricular systolic function and the arising mass coincided, suggesting that chronic inflammation and immunopathological reactions may have influenced the development of CAT from CCMA. Therefore, the rapid progression of CCMA in the development of CAT should especially be considered in patients with inflammatory cardiac comorbidities.
| S-EPMC11886802 | biostudies-literature
Project description: Not available
| S-EPMC8738710 | biostudies-literature
Project description:BackgroundMany previous studies have evaluated the impact of mitral valve (MV) deformity scores on the percutaneous transvenous mitral commissurotomy (PTMC) outcome in patients with mitral stenosis; however, the relationship between mitral annulus calcification (MAC) and the PTMC result has not yet been established. The current study aimed to investigate whether MAC could independently influence the immediate result of PTMC.MethodsOf all patients undergoing PTMC in our institution between April 2005 and November 2009, we included 87 patients (28.7%male, mean ± SD age = 42.8 ± 12.6 years) with rheumatic mitral stenosis who had additional data on the echocardiographic evaluation of MAC along with MV leaflets morphology. Echocardiographic assessments were repeated up to six weeks after PTMC to evaluate the immediate PTMC outcome. The frequency of the optimal PTMC result (secondary MV area > = 1.5 cm(2) with > = 25% increase and without final mitral regurgitation grade > 2) was compared between two groups of patients with MAC (n = 17) and those without MAC (n = 70).ResultsThe optimal result was obtained in 55 (63.2%) patients, whereas the result was suboptimal in 32 (36.8%) patients due to insufficient MV area increase in 31(96.9%) subjects and post-procedure mitral regurgitation grade > 2 in 1(3.1%). The rate of optimal PTMC results was less in patients with MAC in comparison to those without MAC (29.4% vs.71.4%). After adjustments for possible confounders such as age and leaflets morphological subcomponents (thickening, mobility, calcification, and subvalvular thickening), MAC remained a significant negative predictor of a suboptimal PTMC result (odds ratio = 0.154; 95%CI = 0.038-0.626, p value = 0.009) together with leaflet thickening (odds ratio = 0.214; 95%CI = 0.060-0.770, p value = 0.018).ConclusionsMAC appeared to independently influence the immediate result of PTMC; therefore, mitral annulus evaluation may be considered in the echocardiographic assessment of the mitral apparatus prior to PTMC.
| S-EPMC3217870 | biostudies-literature