ArticleEchocardiography (Mount Kisco, N.Y.)2026
Mitral Annular Calcification and Its Severity in Relation to Left Atrial Reservoir Strain and a Non-Invasive Left Atrial Stiffness Index.
Article in Echocardiography (Mount Kisco, N.Y.), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeMitral annular calcification (MAC) is associated with atrial fibrillation and diastolic dysfunction, but its relationship with left atrial (LA) mechanics is poorly defined. The ratio of E/e' to LA reservoir strain (LASr) is a non-invasive surrogate of, not a direct measure of, LA stiffness. We assessed MAC and its severity against LASr and this LA stiffness index (LASI).
methodsIn this single-center cross-sectional study with prospective recruitment, 112 adults in sinus rhythm with ejection fraction ≥50% (58 with MAC, 54 age- and sex-similar controls) underwent two-dimensional speckle-tracking echocardiography. MAC was graded mild to severe; LASI was calculated as E/e' divided by LASr.
resultsLASr was lower (23.2 ± 7.8% vs. 26.7 ± 7.7%, p = 0.018) and LASI higher (0.57 ± 0.30 vs. 0.34 ± 0.20, p < 0.001) in the MAC group. In models excluding the index components, MAC severity was independently associated with higher LASI (β = 0.41, p < 0.001) and MAC presence with lower LASr (-3.6 points, p = 0.016). After clinical adjustment, each 0.1-unit LASI increase was associated with MAC (odds ratio 1.71, 95% CI[1.34-2.17]). LASI discriminated MAC with an area under the curve of 0.762 (0.674-0.851; cut-off 0.31, sensitivity 79%, specificity 63%), which did not differ from E/e' (p = 0.52) or LA volume index (p = 0.48).
conclusionMAC and its severity were associated with impaired LA reservoir function and a higher non-invasive stiffness index. The index did not discriminate MAC better than its simpler components, so these cross-sectional findings are hypothesis-generating.
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