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European Journal of Echocardiography Advance Access published online on June 9, 2008
European Journal of Echocardiography, doi:10.1093/ejechocard/jen179
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2008. For permissions please email: journals.permissions@oxfordjournals.org

Non-rheumatic annular mitral stenosis: prevalence and characteristics

Mohammad Raza Akram, Tze Chan, Susan McAuliffe and Adrian Chenzbraun*

Department of Cardiology, Royal Liverpool University Hospital, Prescott Street, Liverpool L7 8XP, UK

Received 18 March 2008; accepted after revision 18 May 2008.

* Corresponding author. Tel: +44 151 7063488; fax: +44 151 7065833. E-mail address: a.chenzbraun{at}btinternet.com


  Abstract

Aims: To define the prevalence and characteristics of non-rheumatic annular mitral stenosis (AMS) in a general population as compared with rheumatic mitral stenosis (RMS).

Methods and results: Clinical and echocardiographical variables were assessed in 70 patients with mitral stenosis. AMS and RMS patients were age- and gender-matched for the comparison of echocardiographic variables. Thirteen patients (18.5%) had AMS. Arterial hypertension and hypercholesterolemia were more prevalent in AMS (77 vs. 36% and 75 vs. 27%, respectively, P < 0.05). Mitral annulus calcification severity score (2.2 vs. 1.3, P < 0.05) and left ventricular mass (276 ± 73 vs. 209 ± 57 g, P < 0.05) were significantly higher in AMS. Mitral valve area (MVA) was higher and mean gradient was lower (2.25 ± 0.6 vs.1.9 ± 0.6 cm2, 4 ± 1.2 vs. 5.6 ± 3.5 mmHg, P = ns) in AMS. Pressure half-time (PHT) MVA and planimetry MVA had a better correlation in RMS than in AMS patients (r = 0.98 vs. 0.71, P < 0.05).

Conclusion: AMS is more frequent than that is assumed and is associated with risk factors for coronary artery disease. AMS is generally mild and PHT may be less accurate for MVA calculation than in RMS.

Keywords: Mitral stenosis; Mitral annulus calcification; Echocardiography; Risk factors


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