Frequency and significance of mitral anular calcium in hypertrophic cardiomyopathy: analysis of 200 necropsy patients

Abstract

To determine the frequency and significance of mitral anular calcium (MAC) in hypertrophic cardiomyopathy (HC), 43 clinical and morphologic variables in 200 necropsy cases of HC were examined. Of 100 patients less than 40 years of age, none had MAC. Of the 100 necropsy patients greater than 40 years, 30 (30%) had MAC, 21 (70%) of whom were women. The mean age of the 30 MAC patients was older than that of the 70 non-MAC patients greater than 40 years of age (66 years vs 53 years). The frequency of MAC increased with age. MAC was present in 3 of 31 patients (10%) aged 41 to 50 years; in 6 of 34 patients (18%) aged 51 to 60 years; in 11 of 21 patients (52%) aged 61 to 70 years; and in 10 of 14 patients (71%) aged 71 to 90 years. Compared with the 70 patients greater than 40 years of age without MAC, the 30 patients greater than 40 years of age with MAC had higher average systemic arterial peak systolic pressure (133 mm Hg vs 113 mm Hg); a larger percentage of the MAC patients had calcific deposits in the epicardial coronary arteries (93% vs 41%) and in the aortic valve cusps (33% vs 6%); and a larger percentage of the MAC patients had severe narrowing by atherosclerotic plaques of 1 or more of the 4 major epicardial coronary arteries (47% vs 24%). The frequency of a history of systemic hypertension, diabetes mellitus and total serum cholesterol levels greater than 200 mg/dl in the patients with and without MAC was similar.(ABSTRACT TRUNCATED AT 250 WORDS)