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Trends Cardiovasc Med. 2019 Aug 5. pii: S1050-1738(19)30103-3. doi: 10.1016/j.tcm.2019.07.011. [Epub ahead of print]

Mechanisms of mitral annular calcification.

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Leon H. Charney Division of Cardiology, New York University School of Medicine, 530 1st Ave, Skirball 9N, New York, NY, United States. Electronic address:
Cardiology Section, San Francisco Veterans Affairs Health Care System and University of California San Francisco, 4150 Clement St, San Francisco, CA, United States.
British Heart Foundation Centre for Cardiovascular Sciences, University of Edinburgh, 47 Little France Crescent, Edinburgh, United Kingdom.


The mitral annulus is a fibrous structure that surrounds the mitral valve leaflets and is prone to calcification. Despite its common occurrence, association with cardiovascular morbidity and mortality and relationship with dysfunction of the mitral valve, the pathobiology of mitral annular calcification is incompletely understood. Mitral annular calcification is no longer regarded as a local, chronic and degenerative process resulting in precipitation of calcium and phosphate, but as an active and regulated molecular process that is related to lipid metabolism, hemodynamic stress, chronic kidney disease, bone and mineral metabolism and inflammation. This review summarizes the current evidence examining the pathophysiologic determinants of mitral annular calcification.


Aging; Mitral annular calcification; Valve disease

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