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다국어 초록 (Multilingual Abstract)

Background and Objectives: Mitral annular calcification (MAC) is known to be associated with degenerative processes of the cardiac fibrous skeleton and cardiovascular disease mortality. However, MAC has not been evaluated in an extreme age group (patients ≥90 years of age). In this study, the clinical significance of MAC associated with aging was examined in this age group and compared with MAC associated with aging in a younger (20to 50 years of age) group of patients. Subjects and Methods: We assessed echocardiographic parameters in 43 nonagenarians and 51 young patients. In the nonagenarian group, patient’s age was 92±2 years and 27% were male;in the young control group, patient’s age was 36±9 years and 51% were male. Comprehensive M-mode and Doppler echocardiography, including tissue Doppler imaging, were performed. The frequency and severity of MAC was assessed from the leading anterior to the trailing posterior edge at its largest width for least 3 cardiac cycles. Results:Echocardiography showed that the left ventricular (LV) end-diastolic dimension was larger in the young controls (p=0.007); however, the ejection fraction (EF) was lower in the nonagenarian group (p=0.001). The frequency of MAC was greater in nonagenarians {42/43 (97%)} than in controls {9/51 (17%), p<0.0001}. The maximal width of MAC was larger in nonagenarians (0.52±0.17 mm and 0.05±0.13 mm, p<0.0001). MAC was correlated with LV mass index (g/m2) (r=0.280, p=0.014) and EF (%) (r=-0.340, p=0.001). More importantly, early mitral inflow velocity/early diastolic mitral annulus velocity (E/E’) was strongly correlated with MAC in non-agenarians (r=0.683, p<0.0001). Conclusion: MAC may be associated with extreme age and increased LV filling pressure in nonagenarians.
Further study is necessary to assess the cardiovascular mortality and structural changes related to mitral annulus calcification associated with aging.

참고문헌 (Reference)

1 김성훈, "좌심방 석회화와 관련된 반복된 좌심방 혈전 1예" 대한심장학회 34 (34): 323-327, 2004

2 한승환, "관상동맥경화와 허혈성 심질환의 예측인자로서대동맥경직도 측정의 의의" 대한심장학회 34 (34): 468-476, 2004

3 Roberts WC, "The senile cardiac calcification syndrome" 58 : 572-574, 1986

4 Park KS, "The effects of excimer laser coronary angioplasty in calcified lesions:investigation with intravascular ultrasound" 24 : 609-616, 1994

5 D’Cruz I, "Submitral calcification or sclerosis in elderly patients:M-mode and two-dimensional echocardiography in"mitral annulus calcification."" 44 : 31-38, 1979

6 Lang RM, "Recommendations for chamber quantification:a report from the American Society of Echocardiography’s Guidelines and Standards Committee and the Chamber Quantification Writing Group,developed in conjunction with the European Association of Echocardiography,a branch of the European Society of Cardiology" 18 : 1440-1463, 2005

7 Park SH, "Quantative analysis of mitral valvular calcification in mitral stenosis" 24 : 38-52, 1994

8 Mintz GS, "Patterns of calcification in coronary artery disease:a statistical analysis of intravascular ultrasound and coronary angiography in 1155 lesions" 91 : 1959-1965, 1995

9 Pomerance A, "Pathology of the heart with and without cardiac failure in the aged" 27 : 697-710, 1965

10 Adler Y, "Mitral annular calcium detected by transthoracic echocardiography is a marker for high prevalence and severity of coronary artery disease in patients undergoing coronary angiography" 82 : 1183-1186, 1998