Journal of Cardiovascular Imaging

Korean Society of Echocardiography (한국심초음파학회)
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Mitral Annulus Calcification and Cardiac Conduction Disturbances: A DANCAVAS Sub-study

  • Jeppe Holm Rasmussen (Department of Cardiology, Odense University Hospital) ;
  • Maise Hoeigaard Fredgart (Department of Cardiology, Odense University Hospital) ;
  • Jes Sanddal Lindholt (Department of Cardiothoracic and Vascular Surgery, Odense University Hospital) ;
  • Jens Brock Johansen (Department of Cardiology, Odense University Hospital) ;
  • Niels Sandgaard (Department of Cardiology, Odense University Hospital) ;
  • Abdulrahman Haj Yousef (Department of Cardiology, Odense University Hospital) ;
  • Selma Hasific (Department of Cardiology, Odense University Hospital) ;
  • Pernille Sonderskov (Department of Cardiology, Odense University Hospital) ;
  • Flemming Hald Steffensen (Department of Cardiology, Lillebaelt Hospital) ;
  • Lars Frost (Department of Cardiology, Regional Hospital Central Jutland) ;
  • Jess Lambrechtsen (Department of Cardiology, Svendborg Hospital) ;
  • Marek Karon (Department of Medicine, Nykoebing Falster Hospital) ;
  • Martin Busk (Department of Cardiology, Lillebaelt Hospital) ;
  • Grazina Urbonaviciene (Department of Cardiology, Regional Hospital Central Jutland) ;
  • Kenneth Egstrup (Department of Cardiology, Svendborg Hospital) ;
  • Axel Cosmus Pyndt Diederichsen (Department of Cardiology, Odense University Hospital)
  • Received : 2021.06.24
  • Accepted : 2021.09.27
  • Published : 2022.01.27
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Abstract

BACKGROUND: Due to its location very close to the bundle of His, mitral annulus calcification (MAC) might be associated with the development of atrioventricular (AV) conduction disturbances. This study assessed the association between MAC and AV conduction disturbances identified by cardiac implantable electronic device (CIED) use and electrocardiographic parameters. The association between MAC and traditional cardiovascular risk factors was also assessed. METHODS: This cross-sectional study analyzed 14,771 participants, predominantly men aged 60-75 years, from the population-based Danish Cardiovascular Screening trial. Traditional cardiovascular risk factors were obtained. Using cardiac non-contrast computed tomography imaging, MAC scores were measured using the Agatston method and divided into absent versus present and score categories. CIED implantation data were obtained from the Danish Pacemaker and Implantable Cardioverter Defibrillator Register. A 12-lead electrocardiogram was available for 2,107 participants. Associations between MAC scores and AV conduction disturbances were assessed using multivariate regression analyses. RESULTS: MAC was present in 22.4% of the study subjects. Participants with pacemakers for an AV conduction disturbance had significantly higher MAC scores (odds ratio [OR], 1.11; 95% confidence interval [CI], 1.01-1.23) than participants without a CIED, whereas participants with a CIED for other reasons did not. Prolonged QRS-interval was significantly associated with the presence of MAC (OR, 1.45; 95% CI, 1.04-2.04), whereas prolonged PQ-interval was not. Female sex and most traditional cardiovascular risk factors were significantly associated with high MAC scores. CONCLUSIONS: MAC was associated with AV conduction disturbances, which could improve our understanding of the development of AV conduction disturbances.

Keywords

Acknowledgement

This study was supported by the University of Southern Denmark and the Region of Southern Denmark.

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