Mitral Annulus Calcification and Cardiac Conduction Disturbances: A DANCAVAS Sub-study

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  • Jeppe Holm Rasmussen, University of Southern Denmark
  • ,
  • Maise Hoeigaard Fredgart, University of Southern Denmark
  • ,
  • Jes Sanddal Lindholt, University of Southern Denmark
  • ,
  • Jens Brock Johansen, University of Southern Denmark
  • ,
  • Niels Sandgaard, University of Southern Denmark
  • ,
  • Abdulrahman Haj Yousef, University of Southern Denmark
  • ,
  • Selma Hasific, University of Southern Denmark
  • ,
  • Pernille Sønderskov, University of Southern Denmark
  • ,
  • Flemming Hald Steffensen, Lillebaelt Hospital
  • ,
  • Lars Frost
  • Jess Lambrechtsen, University of Southern Denmark
  • ,
  • Marek Karon, Nykøbing Falster Hospital
  • ,
  • Martin Busk, Lillebaelt Hospital
  • ,
  • Grazina Urbonaviciene
  • Kenneth Egstrup, University of Southern Denmark
  • ,
  • Axel Cosmus Pyndt Diederichsen, University of Southern Denmark

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.

Original languageEnglish
JournalJournal of Cardiovascular Imaging
Pages (from-to)62-75
Number of pages14
Publication statusPublished - Jan 2022

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