ArticleEuropean heart journal2020
Prognostic importance of the transmitral pressure gradient in mitral annular calcification with associated mitral valve dysfunction.
Article in European heart journal, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers.
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Who cites it
30 citing papers in PubMed, 61 citations in OpenAlex.
- Diagnostic performance of computed tomographic angiography-based planimetry for the assessment of mitral stenosis.The international journal of cardiovascular imaging · 2026Article
- Mitral Stenosis in the Multimodality Imaging Era: Pitfalls, Stress Echocardiography, and Integrated Therapeutic Assessment.Diagnostics (Basel, Switzerland) · 2026Review
- Prognostic Impact of Qualitative and Quantitative Mitral Valve Calcification in Transapical Transcatheter Mitral Valve Replacement: A Sub-Analysis of the TENDER Registry.Journal of clinical medicine · 2026Article
- Two Faces of Mitral Stenosis: Uncovering Structural and Hemodynamic Signatures of Rheumatic and Mitral Annular Calcification-Induced Disease.Journal of the American Heart Association · 2026Article
- Pearls and pitfalls in the diagnosis and management of mitral annular calcification.Heart (British Cardiac Society) · 2026Article
- Continuous-wave Doppler interrogation in valvular heart disease: pearls and pitfalls.European heart journal. Imaging methods and practice · 2026Review
- Impact of left-heart myopathy on mitral valve stenosis assessment and interventional outcomes: anEuropean heart journal. Digital health · 2026Article
- Elevated Trans-mitral Pressure Gradient Predicts Surgery in Young People with Moderate-Severe Rheumatic Mitral Regurgitation.Pediatric cardiology · 2025Article
- Mitral annular calcification: implications on clinical outcomes and interventions.Annals of cardiothoracic surgery · 2025Review
- Intravascular Lithotripsy in Mitral Annulus Calcification-Related Mitral Stenosis: Hope or Hype?Structural heart : the journal of the Heart Team · 2025Article
- Mitral annular calcification in interventional cardiology: address all fears.AsiaIntervention · 2025Review
- Mitral annular calcification score by computed tomography in patients undergoing mitral valve surgery.European heart journal. Imaging methods and practice · 2025Article
- Mitral Annular Calcification: Understanding the Disease and Treatment Options.Structural heart : the journal of the Heart Team · 2025Review
- Valvular calcification in chronic kidney disease: new insights from recent clinical and preclinical studies.Clinical kidney journal · 2025Article
- Transcatheter aortic valve implantation for combined aortic and mitral stenoses: Insights from the OCEAN-TAVI Registry.ESC heart failure · 2024Article
- 2023 Korean Society of Echocardiography position paper for the diagnosis and management of valvular heart disease, part II: mitral and tricuspid valve disease.Journal of cardiovascular imaging · 2024Review
- Right Ventricular-Pulmonary Arterial Coupling and All-Cause Mortality in Patients with Mitral Annular Calcification-Related Mitral Valve Dysfunction.Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography · 2024Article
- Mitral Annular Calcification-Related Valvular Disease: A Challenging Entity.Journal of clinical medicine · 2024Review
- Feasibility and Outcomes of Mitral Transcatheter Edge-To-Edge Repair in Patients With Variable Degrees of Mitral Annular Calcification.Journal of the American Heart Association · 2023Article
- Risk Factors and Outcomes With Progressive Mitral Annular Calcification.Journal of the American Heart Association · 2023Article
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Authors and funding
12 authors at 1 institution in 1 country.
Funding
Abstract
aimsThe aim of this study was to define the natural history of patients with mitral annular calcification (MAC)-related mitral valve dysfunction and to assess the prognostic importance of mean transmitral pressure gradient (MG) and impact of concomitant mitral regurgitation (MR). METHODS AND
resultsThe institutional echocardiography database was examined from 2001 to 2019 for all patients with MAC and MG ≥3 mmHg. A total of 5754 patients were stratified by MG in low (3-5 mmHg, n = 3927), mid (5-10 mmHg, n = 1476), and high (≥10 mmHg, n = 351) gradient. The mean age was 78 ± 11 years, and 67% were female. MR was none/trace in 32%, mild in 42%, moderate in 23%, and severe in 3%. Primary outcome was all-cause mortality, and outcome models were adjusted for age, sex, and MAC-related risk factors (hypertension, diabetes, coronary artery disease, chronic kidney disease). Survival at 1, 5, and 10 years was 77%, 42%, and 18% in the low-gradient group; 73%, 38%, and 17% in the mid-gradient group; and 67%, 25%, and 11% in the high-gradient group, respectively (log-rank P < 0.001 between groups). MG was independently associated with mortality (adjusted HR 1.064 per 1 mmHg increase, 95% CI 1.049-1.080). MR severity was associated with mortality at low gradients (P < 0.001) but not at higher gradients (P = 0.166 and 0.372 in the mid- and high-gradient groups, respectively).
conclusionIn MAC-related mitral valve dysfunction, mean transmitral gradient is associated with increased mortality after adjustment for age, sex, and MAC-related risk factors. Concomitant MR is associated with excess mortality in low-gradient ranges (3-5 mmHg) but gradually loses prognostic importance at higher gradients, indicating prognostic utility of transmitral gradient in MAC regardless of MR severity.
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