Acartürk Esmeray, Bozkurt Abdi, Cayli Murat, Demir Mesut
Department of Cardiology, Cukurova University, School of Medicine, 01330 Adana, Turkey.
Angiology. 2003 Sep-Oct;54(5):561-7. doi: 10.1177/000331970305400505.
Mitral annular calcification (MAC) and aortic valve calcification (AVC) are manifestations of atherosclerosis. To determine whether mitral annular calcification and aortic valve calcification detected by transthoracic echocardiography (TTE) might help in predicting significant coronary artery disease (CAD), 123 patients with significant CAD and 93 patients without CAD detected by coronary angiography were investigated. MAC and AVC identified CAD with a sensitivity and specificity of 60.2%, 55.9% and 74.8%, 52.7%, respectively, and with a negative and a positive predictive values of 51.5%, 64.3% and 61.3% and 67.6%, respectively. The positive predictive value of MAC was greater than gender, hypertension, and hypercholesterolemia. AVC showed a positive predictive value greater than gender, hypertension, family history, and hypercholesterolemia. The negative predictive values of MAC and AVC for CAD were greater than those of all risk factors except diabetes mellitus. In conclusion, presence of MAC and AVC on TTE may help in predicting CAD and should be added to conventional risk factors. Absence of MVC and AVC is a stronger predictor for absence of CAD than all conventional risk factors, except diabetes mellitus. Patients with MAC and AVC should be taken into consideration for the presence of significant CAD and thereby for diagnostic and therapeutic interventions in order to improve the prognosis.
二尖瓣环钙化(MAC)和主动脉瓣钙化(AVC)是动脉粥样硬化的表现。为了确定经胸超声心动图(TTE)检测到的二尖瓣环钙化和主动脉瓣钙化是否有助于预测严重冠状动脉疾病(CAD),我们对123例经冠状动脉造影确诊为严重CAD的患者和93例无CAD的患者进行了研究。MAC和AVC识别CAD的敏感性和特异性分别为60.2%、55.9%和74.8%、52.7%,阴性预测值和阳性预测值分别为51.5%、64.3%和61.3%、67.6%。MAC的阳性预测值高于性别、高血压和高胆固醇血症。AVC的阳性预测值高于性别、高血压、家族史和高胆固醇血症。MAC和AVC对CAD的阴性预测值高于除糖尿病外的所有危险因素。总之,TTE显示存在MAC和AVC可能有助于预测CAD,应将其纳入传统危险因素。除糖尿病外,不存在MVC和AVC是预测不存在CAD的比所有传统危险因素更强的指标。对于存在MAC和AVC的患者,应考虑到其存在严重CAD,从而进行诊断和治疗干预以改善预后。