Evidence map›Paper›PMID 38986657›Full record

ArticleJACC. Cardiovascular interventions2024

Staging Extramitral Cardiac Damage in Mitral Annular Calcification With Mitral Valve Dysfunction.

Abdullah Al-Abcha, Muhannad Abbasi, Edward El-Am, Atefeh Ghorbanzadeh, Alexander Lee, Christopher G Scott, Jeremy J Thaden, Mackram Eleid, Charanjit Rihal, Jae Oh and 2 more

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Article in JACC. Cardiovascular interventions, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. Review
  2. Review
  3. Mitral Annular Calcification: Natural History, Prognosis, and Clinical Outcomes.Journal of the Society for Cardiovascular Angiography & Interventions · 2025
    Article
  4. Mitral Annular Calcification: Understanding the Disease and Treatment Options.Structural heart : the journal of the Heart Team · 2025
    Review
  5. Article
  6. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

12 authors.

Abdullah Al-AbchaDepartment of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA.
Muhannad AbbasiDepartment of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA.
Edward El-AmDepartment of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA.
Atefeh GhorbanzadehDepartment of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA.
Alexander LeeDepartment of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA.
Christopher G ScottDepartment of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA.
Jeremy J ThadenDepartment of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA.
Mackram EleidDepartment of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA.
Charanjit RihalDepartment of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA.
Jae OhDepartment of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA.
Patricia A PellikkaDepartment of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA.
Mayra E GuerreroDepartment of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA. Electronic address: guerrero.mayra@mayo.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMitral annular calcification (MAC) is a progressive degenerative process associated with comorbidities and increased mortality. A staging system that considers extramitral cardiac damage in MAC may help improve patient selection for mitral valve interventions.

objectivesThis study sought to develop a transthoracic echocardiogram (TTE)-based cardiac staging system in patients with MAC and significant mitral valve dysfunction and assess its prognostic utility.

methodsWe retrospectively evaluated all adults who underwent TTE over 1 year at Mayo Clinic with MAC and significant mitral valve dysfunction defined as mitral stenosis and/or at least moderate mitral regurgitation. Patients were categorized into 5 stages according to extramitral cardiac damage by TTE. All-cause mortality and heart failure hospitalization were assessed.

resultsFor the 953 included patients, the mean age was 76.2 ± 10.7 years, and 54.0% were women. Twenty-eight (2.9%) patients were classified in stages 0 to 1, 499 (52.4%) in stage 2, 115 (12.1%) in stage 3, and 311 (32.6%) in stage 4. At the 3.8-year follow-up, mortality was significantly higher in patients in stages 2 to 4 compared to stages 0 to 1 and increased with each stage. Survival differences were maintained after adjustment for age, diabetes mellitus, and glomerular filtration rate. The rate of heart failure hospitalization was significantly higher in stages 3 and 4 compared to stages 0 to 1. Similar results were observed in subgroup analysis in patients with moderate or severe MAC, predominant mitral stenosis, or predominant mitral regurgitation.

conclusionsUsing the proposed extramitral cardiac damage staging system in patients with MAC and significant mitral valve dysfunction, more advanced stages are associated with higher mortality.

Indexed as

CalcinosisHeart FailureMitral ValveMitral Valve InsufficiencyMitral Valve StenosisPredictive Value of TestsSeverity of Illness IndexAgedAged, 80 and overEchocardiographyFemaleHumansMaleMiddle AgedMinnesotaPrognosisall-cause mortalitycardiac damagemitral annular calcificationstaging system

Identifiers

PMID38986657

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.