Cardiovascular Risk Factors Associated with Mitral Annular Calcification in a Non-Rheumatic Population: Cardiovascular Risk Factors

Mahboob ur Rehman; Muhammad Faisal; Anwar Ali; Mohmmad Iqbal; Asma Rauf; Amjad Abrar

doi:10.54393/pjhs.v5i09.2035

Authors

Mahboob ur Rehman Department of Cardiology, Pakistan Institute of Medical Sciences, Islamabad, Pakistan
Muhammad Faisal Department of Community Medicine, Gomal Medical College, Dera Ismail Khan, Pakistan
Anwar Ali Department of Cardiology, Kulsum International Hospital, Islamabad, Pakistan
Mohmmad Iqbal Department of Cardiac Surgery, Pakistan Institute of Medical Sciences, Islamabad, Pakistan
Asma Rauf Department of Cardiology, Bilal Hospital, Rawalpindi, Pakistan
Amjad Abrar Department of Cardiology, Gomal Medical College, Dera Ismail Khan, Pakistan

DOI:

https://doi.org/10.54393/pjhs.v5i09.2035

Keywords:

Echocardiography, Mitral Annular Calcification, Non-Rheumatic Population, Hypertension

Abstract

Mitral Annular Calcification (MAC), cardiovascular disease marker was common in non-rheumatic populations but was frequently disregarded in clinical evaluations. Objective: To MAC and to assess effect of these factors on cardiac function in non-rheumatic adult population. Methods: From September 2022 to August 2023, we conducted this cross-sectional study at Cardiac Center, Pakistan institute of medical sciences Islamabad that included 182 adults aged 50 years and older. We evaluated the patient's clinical history, demographic data and echocardiographic and laboratory results. The association between the presence of MAC and cardiovascular risk factors (age, hypertension, diabetes, dyslipidemia, smoking, obesity and chronic renal disease) was analyzed using logistic regression. Echocardiographic data were used to provide insight into cardiac function. Results: The prevalence of MAC was substantially correlated with hypertension (OR = 2.30), diabetes (OR = 2.00), dyslipidemia (OR = 1.75) and obesity (OR = 1.07). Also, smoking demonstrated a significant correlation with MAC. In comparison to those without MAC, individuals with MAC exhibited substantially lower ejection fractions, increased left atrial diameters and impaired diastolic function, as indicated by cardiac function assessments. Conclusion: In non-rheumatic population, MAC was significantly associated with conventional cardiovascular risk factors, particularly hypertension and diabetes.

References

Museedi AS and Le Jemtel TH. Mitral Annular Calcification-Related Valvular Disease: A Challenging Entity. Journal of Clinical Medicine. 2024 Feb; 13(3): 896. doi: 10.3390/jcm13030896. DOI: https://doi.org/10.3390/jcm13030896

Kim D, Shim CY, Hong GR, Jeong H, Ha JW. Morphological and functional characteristics of mitral annular calcification and their relationship to stroke. PLOS One. 2020 Jan; 15(1): e0227753. doi: 10.1371/journal.pone.0227753. DOI: https://doi.org/10.1371/journal.pone.0227753

Olvera Lopez E, Ballard BD, Jan A. Cardiovascular Disease. Stat Pearls. Treasure Island (FL): Stat Pearls Publishing. 2020 August.

Gusev E and Sarapultsev A. Atherosclerosis and inflammation: insights from the theory of general pathological processes. International Journal of Molecular Sciences. 2023 Apr; 24(9): 7910. doi: 10.3390/ijms24097910. DOI: https://doi.org/10.3390/ijms24097910

Hou P, Fang J, Liu Z, Shi Y, Agostini M, Bernassola F et al. Macrophage polarization and metabolism in atherosclerosis. Cell Death & Disease. 2023 Oct; 14(10): 691. doi: 10.1038/s41419-023-06206-z. DOI: https://doi.org/10.1038/s41419-023-06206-z

Aksoy F, Guler S, Kahraman F, Kuyumcu MS, Bagcı A, Bas HA et al. The relationship between mitral annular calcification, metabolic syndrome and thromboembolic risk. Brazilian Journal of Cardiovascular Surgery. 2019 Nov; 34: 535-41. doi: 10.21470/1678-9741-2019-0062. DOI: https://doi.org/10.21470/1678-9741-2019-0062

Berberich AJ and Hegele RA. A modern approach to dyslipidemia. Endocrine Reviews. 2022 Aug; 43(4): 611-53. doi: 10.1210/endrev/bnab037. DOI: https://doi.org/10.1210/endrev/bnab037

Wazir M, Olanrewaju OA, Yahya M, Kumari J, Kumar N, Singh J et al. Lipid Disorders and Cardiovascular Risk: A Comprehensive Analysis of Current Perspectives. Cureus. 2023 Dec; 15(12). doi: 10.7759/cureus.51395. DOI: https://doi.org/10.7759/cureus.51395

Kucia AM, Hartley A. Risk factors for cardiovascular disease. In: Kucia AM, Jones ID, editors. Cardiac care: a practical guide for nurses. 2nd ed. Hoboken: Wiley; 2022. p. 71-89. DOI: https://doi.org/10.1002/9781119117810.ch5

Rezaianzadeh A, Moftakhar L, Seif M. Incidence and risk factors of cardiovascular disease among population aged 40–70 years: a population-based cohort study in the South of Iran. Trop Med Health. 2023;51(35). doi:10.1186/s41182-023-00527-7. DOI: https://doi.org/10.1186/s41182-023-00527-7

Adhikary D, Barman S, Ranjan R, Stone H. A Systematic Review of Major Cardiovascular Risk Factors: A Growing Global Health Concern. Cureus. 2022 Oct 10;14(10):e30119. doi: 10.7759/cureus.30119. DOI: https://doi.org/10.7759/cureus.30119

Teo KK, Rafiq T. Cardiovascular risk factors and prevention: a perspective from developing countries. Can J Cardiol. 2021;37(5):733-743. doi:10.1016/j.cjca.2021.02.009. DOI: https://doi.org/10.1016/j.cjca.2021.02.009

Mukhopadhay S, Mukherjee A, Khanra D. Cardiovascular disease risk factors among undergraduate medical students in a tertiary care centre of eastern India: a pilot study. Egypt Heart J. 2021;73(94). doi:10.1186/s43044-021-00219-9. DOI: https://doi.org/10.1186/s43044-021-00219-9

Dos Santos AC, Dos Santos BR, Dos Santos BB, de Moura EL, Ferreira JM, Dos Santos LK et al. Genetic polymorphisms as multi-biomarkers in severe acute respiratory syndrome (SARS) by coronavirus infection: A systematic review of candidate gene association studies. Infection, Genetics and Evolution. 2021 Sep; 93: 104846. doi: 10.1016/j.meegid.2021.104846. DOI: https://doi.org/10.1016/j.meegid.2021.104846

Kanjanauthai S, Nasir K, Katz R, Rivera JJ, Takasu J, Blumenthal RS et al. Relationships of mitral annular calcification to cardiovascular risk factors: the Multi-Ethnic Study of Atherosclerosis (MESA). Atherosclerosis. 2010 Dec; 213(2): 558-62. doi: 10.1016/j.atherosclerosis.2010.08.072. DOI: https://doi.org/10.1016/j.atherosclerosis.2010.08.072

Serdar CC, Cihan M, Yücel D, Serdar MA. Sample size, power and effect size revisited: simplified and practical approaches in pre-clinical, clinical and laboratory studies. Biochemia Medica. 2021 Feb; 31(1): 27-53. doi: 10.11613/BM.2021.010502. DOI: https://doi.org/10.11613/BM.2021.010502

Arts J, Fernandez ML, Lofgren IE. Coronary heart disease risk factors in college students. Adv Nutr. 2014;5(2):177-187. doi:10.3945/an.113.005447. DOI: https://doi.org/10.3945/an.113.005447

de Almeida AJ, de Almeida Rezende MS, Dantas SH, de Lima Silva S, de Oliveira JC, de Lourdes Assunção Araújo de Azevedo F. Unveiling the role of inflammation and oxidative stress on age‐related cardiovascular diseases. Oxidative Medicine and Cellular Longevity. 2020 May; 2020(1): 1954398. doi: 10.1155/2020/1954398. DOI: https://doi.org/10.1155/2020/1954398

Singh S, Shankar R, Singh GP. Prevalence and Associated Risk Factors of Hypertension: A Cross‐Sectional Study in Urban Varanasi. International Journal of Hypertension. 2017 Dec; 2017(1): 5491838. doi: 10.1155/2017/5491838. DOI: https://doi.org/10.1155/2017/5491838

Maharani A, Sujarwoto, Praveen D, Oceandy D, Tampubolon G, Patel A. Cardiovascular disease risk factor prevalence and estimated 10-year cardiovascular risk scores in Indonesia: The SMARThealth Extend study. PLoS One. 2019;14(4):215219. doi:10.1371/journal.pone.0215219. DOI: https://doi.org/10.1371/journal.pone.0215219

Banks E, Welsh J, Joshy G, Martin M, Paige E, Korda RJ. Comparison of cardiovascular disease risk factors, assessment and management in men and women, including consideration of absolute risk: a nationally representative cross-sectional study. BMJ Open. 2020;10(12):1136. doi:10.1136/bmjopen-2020-000000. DOI: https://doi.org/10.1136/bmjopen-2020-038761

Ghamri RA, Alzahrani NS, Alharthi AM, et al. Cardiovascular risk factors among high-risk individuals attending the general practice at King Abdulaziz University Hospital: a cross-sectional study. BMC Cardiovasc Disord. 2019;19(268). doi:10.1186/s12872-019-1261-6. DOI: https://doi.org/10.1186/s12872-019-1261-6

Ariyanti R and Besral B. Dyslipidemia associated with hypertension increases the risks for coronary heart disease: a case‐control study in Harapan Kita Hospital, National Cardiovascular Center and Jakarta. Journal of Lipids. 2019 Apr; 2019(1): 2517013. doi: 10.1155/2019/2517013. DOI: https://doi.org/10.1155/2019/2517013

Bays HE, Taub PR, Epstein E. Ten things to know about ten cardiovascular disease risk factors. Am J Prev Cardiol. 2021;5:100149. doi:10.1016/j.ajpc.2021.100149. DOI: https://doi.org/10.1016/j.ajpc.2021.100149

Yusuf S, Joseph P, Rangarajan S, Islam S, Mente A, Hystad P, Brauer M, Kutty VR, Gupta R, Wielgosz A, AlHabib KF, Dans A, Lopez-Jaramillo P, Avezum A, Lanas F, Oguz A, Kruger IM, Diaz R, Yusoff K, Mony P, Chifamba J, Yeates K, Kelishadi R, Yusufali A, Khatib R, Rahman O, Zatonska K, Iqbal R, Wei L, Bo H, Rosengren A, Kaur M, Mohan V, Lear SA, Teo KK, Leong D, O'Donnell M, McKee M, Dagenais G. Modifiable risk factors, cardiovascular disease, and mortality in 155 722 individuals from 21 high-income, middle-income, and low-income countries (PURE): a prospective cohort study. Lancet. 2020 Mar 7;395(10226):795-808. doi: 10.1016/S0140-6736(19)32008-2. DOI: https://doi.org/10.1016/S0140-6736(19)32008-2

Kato Y, Arimura T, Shiga Y, Kuwano T, Sugihara M, Miura SI. Association between mitral annulus calcification and subtypes of heart failure rehospitalization. Cardiology Journal. 2023 Apr; 30(2): 256-65. doi: 10.5603/CJ.a2021.0076. DOI: https://doi.org/10.5603/CJ.a2021.0076