Impact of mitral annular calcification on left atrial volumes and function

Background: Mitral annular calcification (MAC) is a chronic degenerative process that may play a role in conditions as; left atrial enlargement, left ventricular enlargement, atrial fibrillation and stroke. There may be a link between MAC and LA function. Aim of the work: To study the relation between MAC with LA volume and function. Patients and methods: This study included 80 cases subjected to: history and physical examination, ECG, Transthoracic echocardiography to detect: MAC and its severity, LA dimension, LA volumes, LV ejection fraction and transmitral Doppler flow. The patients divided retrogradely into two groups: group (I): included 50 patients with MAC and group (II): included 30 healthy volunteers. According to MAC severity group (I) subdivided into two subgroups, (A): included 31 patients with mild MAC. (B): included 19 patients with moderate to severe MAC. Results: MAC is highly associated with atherosclerosis risk factors with positive correlation between MAC and CAD. MAC is more common in females. There was significant association between MAC and diastolic dysfunction but not with systolic dysfunction. In-group (1), there was significant prolongation of the P-wave and significant LA enlargement. In addition, there was impaired LA active emptying volume and significantly increased LA passive emptying volume with significantly decreased LA stroke volume and LA active emptying fraction (impaired LA function). The degree of MR is related to the severity of MAC. Conclusion: MAC could serve as an indicator for poor LA function especially the contractile function