Journal
EUROPEAN HEART JOURNAL-CARDIOVASCULAR IMAGING
Volume 23, Issue 3, Pages E111-E122Publisher
OXFORD UNIV PRESS
DOI: 10.1093/ehjci/jeab185
Keywords
echocardiography; cardiac computed tomography; mitral annular calcification; calcium scoring; calcific mitral stenosis; mitral regurgitation; transcatheter mitral valve replacement; transcatheter mitral valve repair; multimodality imaging
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MAC is a condition where calcium deposits in the fibrous skeleton of the mitral valve, with various cardiovascular associations. Echocardiography is the primary imaging modality for evaluation, while cardiac CT plays a significant role in related procedure planning and quantitative grading of MAC.
Mitral annular calcification (MAC) refers to calcium deposition in the fibrous skeleton of the mitral valve. It has many cardiovascular associations, including mitral valve dysfunction, elevated cardiovascular risk, arrhythmias, and endocarditis. Echocardiography conventionally is the first-line imaging modality for anatomic assessment, and evaluation of mitral valve function. Cardiac computed tomography (CT) has demonstrated importance as an imaging modality for the evaluation and planning of related procedures. It also holds promise in quantitative grading of MAC. Currently, there is no universally accepted definition or classification system of MAC severity. We review the multimodality imaging evaluation of MAC and associated valvular dysfunction and propose a novel classification system based on qualitative and quantitative measurements derived from echocardiography and cardiac CT.
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