Association between coronary tortuosity and mitral annular calcification

Abstract

Introduction: Coronary tortuosity (CorT) is a common coronary angiographic finding. The aetiology, clinical implication and long-term prognosis are not well clarified. Mitral annular calcification (MAC) is one of the most common cardiac structural abnormalities on echocardiographic examination. MAC and CorT are associated with atherosclerotic risk factors such as advanced age, hypertension, diabetes mellitus, hypercholesterolaemia, female gender and chronic kidney disease. There are few data on the co-existence of MAC and CorT in the literature. This study was conducted with the aim of evaluating the association between CorT and MAC.

Methods: The medical records of consecutive patients who underwent coronary angiography were retrospectively reviewed. The study group consisted of 2 736 patients. Taking into consideration the inclusion criteria, 392 patients with MAC and 687 patients without MAC (control group) were included in the study. Biochemical, clinical and echocardiographic parameters and CorT were evaluated in all patients. CorT was defined as three fixed bends during both systole and diastole, with the angle of each bend 45° or more.

Results: Patients with MAC had a higher prevalence of hypertension, hyperlipidaemia, female gender, MAC and advanced age. On univariate analysis, advanced age, hypertension, female gender, hyperlipidaemia and MAC were associated with CorT. On multivariate analysis MAC, advanced age and hypertension were independent predictors for CorT (OR 2.167, 95% CI: 1.436-4.283, p < 0.001; OR 1.243, 95% CI: 1.243-3.674, p < 0.001; OR 2.358, 95% CI: 1.864-4.681, p < 0.001, respectively).

Conclusions: In our study, we found a significant relationship between MAC and CorT.

Keywords: ageing; coronary tortuosity; female gender; hypertension; mitral annular calcification.