Abstract 15375: Relationship Between Mitral Annular Calcifications and Plaque Morphology in Coronary Artery Disease: A Virtual Histology Intravascular Ultrasound(VH-IVUS) Study
Introduction: Patients with mitral annular calcification were found to have increased morbidities and mortality due to atherosclerotic vascular diseases including coronary artery disease, cerebrovascular disease, peripheral artery disease. The impact of mitral annular calcification on the plaque morphology which was analysed with VH-IVUS has not been studied untill now.
Hypothesis: We aimed to investigate the relationship between the presence of mitral annular calcification identified by transthoracic echocardiography and the plaque morphology of target lesion in coronary artery disease as assessed by VH-IVUS.
Methods: We used transthoracic echocardiography to assess and grade mitral annular calcification in 262 patients(pts) with coronary artery disease who underwent VH-IVUS. The group with mitral annular calcification was classified into three sub-categories( mild, moderate, severe ). VH-TCFA (thin-capped fibroatheroma) was defined as necrotic core (NC) >10% of plaque area with a plaque burden of >40% and NC in contact with the lumen for ≥3 image slices. Positive remodeling was defined as remodeling index ( lesion/reference EEM area ) greater than 1.05.
Results: Mitral annular calcification was observed in 108 pts (41.2%). Pts were divided into 2 groups: mitral annular calcification (108 pts) vs no mitral annular calcification (154 pts). Lesion length, minimal lumen area (MLA), vessel size and remodeling index were similar in both groups(Table 1). In VH-IVUS analysis, VH-TCFA was similarly present in both groups. But necrotic core areas at the sites of lesion, minimal lumen area and maximal necrotic core were greater in the group with mitral annular calcification compared to the group without mitral annular calcification(Table 2).
Conclusions: Mitral annular calcification can be a predictor of instability of coronary artery lesion because it may suggest more NC area. This may help identify patients who are predisposed to future vascular events.
Author Disclosures: S. Hyeon: None. S. Kim: None. Y. Kim: None.
- © 2014 by American Heart Association, Inc.