Year: 2025
Type: article
Study design: Observational Study
Abstract: Mitral annular calcification (MAC) and heart failure with preserved ejection fraction (HFpEF) share risk factors but links between the 2 have not been well studied. Using data from the TriNetX US Collaborative Network various cohorts were created which were propensity score matched (by demographics and comorbidities) and used to perform 3 studies: 1) All hospitalized patients between 2020 and 2023, without prior heart failure, were stratified by presence or absence of MAC to assess risk of developing HFpEF at 1 year. 2) Patients with a HFpEF diagnosis were stratified by presence or absence of a new diagnosis of MAC between 2020 and 2023 and evaluated for cardiovascular outcomes at 1 year. 3) Data from study-1 were further explored for interactions between MAC and body-mass index (BMI) in development of HFpEF at 1 year. In study-1, MAC patients were at higher risk of developing HFpEF versus no-MAC (HR 3.80, p < 0.0001). In study-2, HFpEF patients with vs without MAC were at higher risk of HF hospitalization (HR 1.24, p < 0.0001), all-cause hospitalization (HR 1.34, p < 0.0001), and various cardiovascular outcomes. In study-3, incident HFpEF in the no-MAC group was low with a "J-shaped" curve noted across BMI quintiles. MAC patients had a much higher incidence of HFpEF with little influence of BMI except in the highest quintile. In conclusion: MAC is an independent risk factor for development of HFpEF. When present in HFpEF patients, there is increased risk of re-hospitalization and cardiovascular events. MAC has much greater impact on development of HFpEF than does BMI.
Authors: Evan Isaacs, Abiodun Idowu, Maria Helena Siqueira Tavares De Melo, Alexander Rembalsky, Phuuwadith Wattanachayakul, Gregg Pressman
Institution: Jefferson Einstein Philadelphia Hospital
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,380
OpenAlex ID: W4415488539