Vereckei András, Jenei Zsigmond, Vágó Hajnalka, Balla Dorottya, Panajotu Alexisz, Nagy Andrea, Katona Gábor
Department of Medicine and Hematology, Semmelweis University, Szentkirályi u. 46, 1088 Budapest, Hungary.
Heart and Vascular Center, Semmelweis University, Városmajor u. 68, 1112 Budapest, Hungary.
J Cardiovasc Dev Dis. 2025 Jun 18;12(6):233. doi: 10.3390/jcdd12060233.
Mitral annular calcification (MAC) is usually considered an incidental, benign, age-related finding without serious complications in patients evaluated for cardiovascular or pulmonary disease with imaging studies that may result in mitral regurgitation or stenosis when severe. Therefore, it is usually not considered a significant alteration. However, there is accumulating evidence that it is associated with a higher risk of cardiovascular events, such as atherosclerotic coronary artery disease, aortic artery disease, carotid artery disease, peripheral artery disease, stroke, atrial fibrillation, atrioventricular and/or intraventricular conduction disturbance, systemic embolization, infective endocarditis, heart failure and mortality. The presence of MAC also significantly influences the outcome of mitral valve transcatheter and surgical interventions. Several conditions may predispose to MAC. MAC is strongly related to cardiovascular risk factors, such as hypertension, diabetes, smoking and cardiovascular atherosclerosis, and inflammation may also play a role in the pathogenesis of MAC. Also, conditions that increase mitral valve stress, such as hypertension, aortic stenosis and hypertrophic cardiomyopathy, predispose to accelerated degenerative calcification of the mitral annulus area. Congenital disorders, e.g., Marfan syndrome and Hurler syndrome, are also associated with MAC, due to an intrinsic abnormality of the connective tissue composing the annulus.
二尖瓣环钙化（MAC）通常被认为是一种偶然的、良性的、与年龄相关的发现，在接受心血管或肺部疾病评估的患者中，通过影像学检查发现时一般无严重并发症，严重时可能导致二尖瓣反流或狭窄。因此，它通常不被视为一种显著的改变。然而，越来越多的证据表明，它与心血管事件的较高风险相关，如动脉粥样硬化性冠状动脉疾病、主动脉疾病、颈动脉疾病、外周动脉疾病、中风、心房颤动、房室和/或室内传导障碍、系统性栓塞、感染性心内膜炎、心力衰竭和死亡。MAC的存在也显著影响二尖瓣经导管和外科手术干预的结果。几种情况可能易患MAC。MAC与心血管危险因素密切相关，如高血压、糖尿病、吸烟和心血管动脉粥样硬化，炎症也可能在MAC的发病机制中起作用。此外，增加二尖瓣压力的情况，如高血压、主动脉瓣狭窄和肥厚型心肌病，易导致二尖瓣环区域加速退行性钙化。先天性疾病，如马凡综合征和黏多糖贮积症Ⅰ型，也与MAC有关，这是由于构成瓣环的结缔组织存在内在异常。
