Clinical and echocardiographic features of mitral annular calcium in patients aged ≤50 years

Data regarding characteristics of young patients with mitral annular calcification (MAC) and its associations with other cardiovascular risk factors are scarce. Hence, we sought to characterize patients aged <50 years with MAC and to examine whether in these patients, MAC is also associated with cardiovascular risk factors. Consecutive patients who underwent an echocardiographic study were prospectively entered into a database. The database included clinical, laboratory, and echocardiographic parameters. The present study included 56 patients aged <50 years with a diagnosis of MAC. The mean age was 44.2 ± 6.9 years with a male-to-female ratio of 2.5:1. The prevalence of cardiovascular risk factors (30 patients [53%] hypertension, 17 patients [30%] diabetes mellitus, 24 patients [43%] dyslipidemia, 22 patients [39%] smoking) and established cardiovascular disease (22 patients [39%] coronary artery disease, 11 patients [19%] previous stroke) was substantially higher than expected for this age group. Twenty-nine patients (52%) had chronic kidney disease. Of these, 18 patients (62%) had end-stage kidney disease and 7 patients (24%) underwent renal transplantation. Fourteen patients (25%) and 3 patients (5%) had moderate or severe mitral regurgitation and mitral stenosis, respectively. Aortic valve disease was present in 37 patients (66%). Moderate or severe left ventricular dysfunction and left ventricular hypertrophy were identified in 9 patients (16%) and 31 patients (56%), respectively. In conclusion, the detection of MAC in a young patient should be regarded as a marker of atherosclerotic disease, chronic kidney disease, and aortic valve disease.