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• W2317196145 abstract "Mitral annular calcification (MAC) is characterized by degenerative calcification of the mitral valve annulus. Atherosclerosis plays role in progression of MAC. Fetuin A is the inhibitor of pathological calcification. In the present study, we investigated the relationship between MAC and fetuin A with carotid intima media thickness (CIMT) and endothelial dysfunction.In this observational cross-sectional study, 40 patients with documented MAC on transthoracic echocardiography and 40 without MAC were included. All patients had coronary artery disease (CAD). Endothelial functions were assessed by brachial artery Doppler ultrasound (USG) and carotid artery Doppler USG. Serum fetuin-A level was also measured. Linear regression analysis and receiver operator curve analysis were performed.Endothelial derived vasodilatory response (EDVR) was significantly decreased and CIMT value was increased in MAC group. There was a strong positive correlation between EDVR and serum fetuin-A value. There was a strong negative correlation between CIMT and EDVR, moderately negative correlation between CIMT and serum fetuin-A level. Simple linear regression analysis revealed that CIMT (β=0.367, p=0.001) and serum fetuin-A level (β=-0.291, p=0.009) were independent factors associated with MAC. The area under the curve (AUC) for serum fetuin-A level was 0.731 (95% 0.620-0.824) and AUC for CIMT was 0.724 (95% CI 0.613-0.818).We observed that MAC is closely related with CIMT and serum fetuin-A level. Serum fetuin-A and CIMT can be used as independent markers in the diagnosis of MAC. We suggest that MAC can be used as an early determinant of CAD.AMAÇ: Mitral anüler kalsifikasyon (MAK), mitral kapak anulusunun dejeneratif kalsifikasyonu ile karakterize bir hastalıktır. MAK gelişiminde aterosklerotik mekanizmaların rol oynadığı düşünülmektedir. Fetuin-A, patolojik kalsifikasyonun inhibitörlerindendir. Çalışmamızda; MAK ile, endotel fonksiyon bozukluğu, karotis intima media kalınlığı (KİMK) ve serum fetuin-A düzeyleri arasındaki ilişkiyi inceledik. YÖNTEMLER: Bu gözlemsel, kesitsel çalışmaya, transtorasik ekokardiyografide MAK saptanan 40 hasta ile saptanmayan 40 hasta dahil edildi. Tüm hastalar koroner arter hastası idi. Endotel fonksiyonları brakiyal arter ultrasonografisi (USG), karotis arter Doppler USG ile değerlendirildi. Hastaların Fetuin A düzeyi ölçüldü. Lineer regresyon analizi ve ROC analizi ile istatistiki değerlendirmeler yapıldı.MAK grubundaki ortalama endotele bağımlı vazodilatasyon yanıtı (EBVY) kontrol grubuna göre anlamlı olarak azalmış, ortalama karotis intima media kalınlığı ise artmıştı. EBVY ile serum fetuin-A düzeyi arasında güçlü derecede pozitif korelasyon saptandı. KİMK ile EBVY arasında güçlü derecede negatif korelasyon, KİMK ile fetuin-a arasında ise orta derecede negative korelasyon saptandı. Regresyon analizleri sonucunda KİMK (beta katsayısı 0,367, p=0,001) serum fetuin-A düzeyinin (beta katsayısı-0,291, p=0,001) MAK için bağımsız risk faktörleri olduğu saptandı. Eğri altındaki alan (AUC ) fetuin-A düzeyi için 0,731 (güvenlik aralığı %95), KİMK için AUC değeri 0,724 (güvenlik aralığı %95) saptandı. SONUÇ: Çalışmamız sonucunda MAK'ın, KİMK ve fetuin-A düzeyi ile yakın ilişkili olduğunu göziedik. Serum fetuin-A düzeyi ve KİMK'ın, MAK tanısı için bağımsız belirteçler olabileceğini ve ekokardiyografik inceleme ile kolayca tanısı konulabilen MAK'ın, koroner arter hastalığının erken belirteci olarak kullanılabileceğini düşünmekteyiz." @default.
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• W2317196145 date "2013-10-04" @default.
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• W2317196145 title "Association of mitral annular calcification with endothelial dysfunction, carotid intima-media thickness and serum fetuin-A: an observational study" @default.
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• W2317196145 doi "https://doi.org/10.5152/akd.2013.235" @default.
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