{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T04:38:12Z","timestamp":1766378292346,"version":"3.44.0"},"reference-count":33,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2023,4,1]],"date-time":"2023-04-01T00:00:00Z","timestamp":1680307200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2023,4,1]],"date-time":"2023-04-01T00:00:00Z","timestamp":1680307200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2024,3,5]],"date-time":"2024-03-05T00:00:00Z","timestamp":1709596800000},"content-version":"am","delay-in-days":339,"URL":"http:\/\/www.elsevier.com\/open-access\/userlicense\/1.0\/"},{"start":{"date-parts":[[2023,4,1]],"date-time":"2023-04-01T00:00:00Z","timestamp":1680307200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-017"},{"start":{"date-parts":[[2023,4,1]],"date-time":"2023-04-01T00:00:00Z","timestamp":1680307200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-037"},{"start":{"date-parts":[[2023,4,1]],"date-time":"2023-04-01T00:00:00Z","timestamp":1680307200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-012"},{"start":{"date-parts":[[2023,4,1]],"date-time":"2023-04-01T00:00:00Z","timestamp":1680307200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-029"},{"start":{"date-parts":[[2023,4,1]],"date-time":"2023-04-01T00:00:00Z","timestamp":1680307200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-004"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["1K23HL159262-01A1","R01 HL141917"],"award-info":[{"award-number":["1K23HL159262-01A1","R01 HL141917"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["ajconline.org","clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["The American Journal of Cardiology"],"published-print":{"date-parts":[[2023,4]]},"DOI":"10.1016\/j.amjcard.2023.02.005","type":"journal-article","created":{"date-parts":[[2023,3,5]],"date-time":"2023-03-05T04:51:08Z","timestamp":1677991868000},"page":"83-90","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":8,"special_numbering":"C","title":["Sex Differences in Extensive Mitral Annular Calcification With Associated Mitral Valve Dysfunction"],"prefix":"10.1016","volume":"193","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0215-3049","authenticated-orcid":false,"given":"Timothy W.","family":"Churchill","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Evin","family":"Yucel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samuel","family":"Bernard","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mayooran","family":"Namasivayam","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasufumi","family":"Nagata","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emily S.","family":"Lau","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sebastien","family":"Deferm","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wei","family":"He","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jacqueline S.","family":"Danik","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Danita Y.","family":"Sanborn","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael H.","family":"Picard","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert A.","family":"Levine","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Judy","family":"Hung","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philippe B.","family":"Bertrand","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"78","reference":[{"key":"10.1016\/j.amjcard.2023.02.005_bib0001","doi-asserted-by":"crossref","first-page":"902","DOI":"10.1378\/chest.10-2963","article-title":"Mitral annular calcification predicts cardiovascular morbidity and mortality in middle-aged patients with atrial fibrillation: the Belgrade atrial fibrillation Study","volume":"140","author":"Potpara","year":"2011","journal-title":"Chest"},{"key":"10.1016\/j.amjcard.2023.02.005_bib0002","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1093\/ehjci\/jex093","article-title":"Mitral annular calcification progression and the risk of atrial fibrillation: results from MESA","volume":"19","author":"O'Neal","year":"2018","journal-title":"Eur Heart J Cardiovasc Imaging"},{"key":"10.1016\/j.amjcard.2023.02.005_bib0003","doi-asserted-by":"crossref","first-page":"617","DOI":"10.1016\/j.jcmg.2008.07.006","article-title":"Impact of mitral annular calcification on cardiovascular events in a multiethnic community: the Northern Manhattan Study","volume":"1","author":"Kohsaka","year":"2008","journal-title":"JACC Cardiovasc Imaging"},{"key":"10.1016\/j.amjcard.2023.02.005_bib0004","doi-asserted-by":"crossref","first-page":"1492","DOI":"10.1161\/01.CIR.0000058168.26163.BC","article-title":"Mitral annular calcification predicts cardiovascular morbidity and mortality: the Framingham Heart Study","volume":"107","author":"Fox","year":"2003","journal-title":"Circulation"},{"key":"10.1016\/j.amjcard.2023.02.005_bib0005","doi-asserted-by":"crossref","first-page":"4321","DOI":"10.1093\/eurheartj\/ehaa819","article-title":"Prognostic importance of the transmitral pressure gradient in mitral annular calcification with associated mitral valve dysfunction","volume":"41","author":"Bertrand","year":"2020","journal-title":"Eur Heart J"},{"key":"10.1016\/j.amjcard.2023.02.005_bib0006","doi-asserted-by":"crossref","first-page":"739","DOI":"10.1016\/j.jacc.2022.05.032","article-title":"Mitral valve dysfunction in patients with annular calcification: JACC review topic of the week","volume":"80","author":"Churchill","year":"2022","journal-title":"J Am Coll Cardiol"},{"key":"10.1016\/j.amjcard.2023.02.005_bib0007","doi-asserted-by":"crossref","first-page":"911","DOI":"10.1016\/j.echo.2006.01.017","article-title":"Increased prevalence of mitral stenosis in women","volume":"19","author":"Movahed","year":"2006","journal-title":"J Am Soc Echocardiogr"},{"key":"10.1016\/j.amjcard.2023.02.005_bib0008","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1016\/0002-9149(85)90314-5","article-title":"Frequency of mitral valve dysfunction from mitral anular calcium as detected by Doppler echocardiography","volume":"55","author":"Labovitz","year":"1985","journal-title":"Am J Cardiol"},{"key":"10.1016\/j.amjcard.2023.02.005_bib0009","doi-asserted-by":"crossref","first-page":"1841","DOI":"10.1016\/j.jacc.2018.02.054","article-title":"1-Year Outcomes of Transcatheter Mitral Valve Replacement in Patients With Severe Mitral Annular Calcification","volume":"71","author":"Guerrero","year":"2018","journal-title":"J Am Coll Cardiol"},{"key":"10.1016\/j.amjcard.2023.02.005_bib0010","doi-asserted-by":"crossref","first-page":"611","DOI":"10.1093\/ehjci\/jet105","article-title":"Recommendations for the echocardiographic assessment of native valvular regurgitation: an executive summary from the European Association of Cardiovascular Imaging","volume":"14","author":"Lancellotti","year":"2013","journal-title":"Eur Heart J Cardiovasc Imaging"},{"key":"10.1016\/j.amjcard.2023.02.005_bib0011","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1016\/j.echo.2017.01.007","article-title":"Recommendations for noninvasive evaluation of native valvular regurgitation: a report from the American Society of Echocardiography developed in collaboration with the Society for Cardiovascular Magnetic Resonance","volume":"30","author":"Zoghbi","year":"2017","journal-title":"J Am Soc Echocardiogr"},{"key":"10.1016\/j.amjcard.2023.02.005_bib0012","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.echo.2014.10.003","article-title":"Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging","volume":"28","author":"Lang","year":"2015","journal-title":"J Am Soc Echocardiogr"},{"key":"10.1016\/j.amjcard.2023.02.005_bib0013","doi-asserted-by":"crossref","first-page":"558","DOI":"10.1016\/j.atherosclerosis.2010.08.072","article-title":"Relationships of mitral annular calcification to cardiovascular risk factors: the Multi-Ethnic Study of Atherosclerosis (MESA)","volume":"213","author":"Kanjanauthai","year":"2010","journal-title":"Atherosclerosis"},{"key":"10.1016\/j.amjcard.2023.02.005_bib0014","doi-asserted-by":"crossref","first-page":"1281","DOI":"10.1016\/j.amjcard.2005.11.065","article-title":"Cardiovascular morbidity and mortality in community-dwelling elderly individuals with calcification of the fibrous skeleton of the base of the heart and aortosclerosis (The Cardiovascular Health Study)","volume":"97","author":"Barasch","year":"2006","journal-title":"Am J Cardiol"},{"key":"10.1016\/j.amjcard.2023.02.005_bib0015","doi-asserted-by":"crossref","first-page":"904","DOI":"10.1016\/j.ahj.2013.08.015","article-title":"Risk factors associated with the incidence and progression of mitral annulus calcification: the multi-ethnic study of atherosclerosis","volume":"166","author":"Elmariah","year":"2013","journal-title":"Am Heart J"},{"key":"10.1016\/j.amjcard.2023.02.005_bib0016","doi-asserted-by":"crossref","first-page":"472","DOI":"10.1136\/hrt.78.5.472","article-title":"Cardiac valve calcification: characteristics of patients with calcification of the mitral annulus or aortic valve","volume":"78","author":"Boon","year":"1997","journal-title":"Heart"},{"key":"10.1016\/j.amjcard.2023.02.005_bib0017","doi-asserted-by":"crossref","first-page":"461","DOI":"10.1016\/j.echo.2015.12.012","article-title":"Survival in patients with degenerative mitral stenosis: results from a large retrospective cohort study","volume":"29","author":"Pasca","year":"2016","journal-title":"J Am Soc Echocardiogr"},{"key":"10.1016\/j.amjcard.2023.02.005_bib0018","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1136\/heart.89.2.161","article-title":"Mitral annular calcification: a marker of severe coronary artery disease in patients under 65 years old","volume":"89","author":"Atar","year":"2003","journal-title":"Heart"},{"key":"10.1016\/j.amjcard.2023.02.005_bib0019","doi-asserted-by":"crossref","first-page":"861","DOI":"10.1161\/CIRCULATIONAHA.105.552844","article-title":"Mitral and aortic annular calcification are highly associated with systemic calcified atherosclerosis","volume":"113","author":"Allison","year":"2006","journal-title":"Circulation"},{"key":"10.1016\/j.amjcard.2023.02.005_bib0020","doi-asserted-by":"crossref","first-page":"2491","DOI":"10.1016\/j.jacc.2010.03.019","article-title":"Associations of long-term and early adult atherosclerosis risk factors with aortic and mitral valve calcium","volume":"55","author":"Thanassoulis","year":"2010","journal-title":"J Am Coll Cardiol"},{"key":"10.1016\/j.amjcard.2023.02.005_bib0021","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1016\/j.jacc.2010.11.073","article-title":"Association of serum phosphate levels with aortic valve sclerosis and annular calcification: the cardiovascular health study","volume":"58","author":"Linefsky","year":"2011","journal-title":"J Am Coll Cardiol"},{"key":"10.1016\/j.amjcard.2023.02.005_bib0022","doi-asserted-by":"crossref","first-page":"2941","DOI":"10.1016\/j.jacc.2017.04.051","article-title":"Association of triglyceride-related genetic variants with mitral annular calcification","volume":"69","author":"Afshar","year":"2017","journal-title":"J Am Coll Cardiol"},{"key":"10.1016\/j.amjcard.2023.02.005_bib0023","doi-asserted-by":"crossref","first-page":"1522","DOI":"10.1161\/01.CIR.103.11.1522","article-title":"Bone formation and inflammation in cardiac valves","volume":"103","author":"Mohler","year":"2001","journal-title":"Circulation"},{"key":"10.1016\/j.amjcard.2023.02.005_bib0024","doi-asserted-by":"crossref","first-page":"1707","DOI":"10.1016\/j.jacc.2006.02.040","article-title":"Human degenerative valve disease is associated with up-regulation of low-density lipoprotein receptor-related protein 5 receptor-mediated bone formation","volume":"47","author":"Caira","year":"2006","journal-title":"J Am Coll Cardiol"},{"key":"10.1016\/j.amjcard.2023.02.005_bib0025","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1016\/j.tcm.2019.07.011","article-title":"Mechanisms of mitral annular calcification","volume":"30","author":"Massera","year":"2020","journal-title":"Trends Cardiovasc Med"},{"key":"10.1016\/j.amjcard.2023.02.005_bib0026","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1007\/s11657-017-0347-y","article-title":"Relationship of bone mineral density with valvular and annular calcification in community-dwelling older people: The Cardiovascular Health Study","volume":"12","author":"Massera","year":"2017","journal-title":"Arch Osteoporos"},{"key":"10.1016\/j.amjcard.2023.02.005_bib0027","doi-asserted-by":"crossref","first-page":"1767","DOI":"10.1002\/jbmr.2530","article-title":"QCT volumetric bone mineral density and vascular and valvular calcification: the Framingham study","volume":"30","author":"Chan","year":"2015","journal-title":"J Bone Miner Res"},{"key":"10.1016\/j.amjcard.2023.02.005_bib0028","doi-asserted-by":"crossref","first-page":"1085","DOI":"10.2147\/CIA.S244063","article-title":"Calcification of cardiac valves in metabolic bone disease: an updated review of clinical studies","volume":"15","author":"Carrai","year":"2020","journal-title":"Clin Interv Aging"},{"key":"10.1016\/j.amjcard.2023.02.005_bib0029","doi-asserted-by":"crossref","first-page":"523","DOI":"10.1161\/CIRCULATIONAHA.119.040095","article-title":"Complexity of defining severe \"stenosis\" from mitral annular calcification","volume":"140","author":"Reddy","year":"2019","journal-title":"Circulation"},{"key":"10.1016\/j.amjcard.2023.02.005_bib0030","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1530\/ERP-14-0050","article-title":"Reference values for mitral and tricuspid annular dimensions using two-dimensional echocardiography","volume":"1","author":"Dwivedi","year":"2014","journal-title":"Echo Res Pract"},{"key":"10.1016\/j.amjcard.2023.02.005_bib0031","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1016\/j.jchf.2019.01.004","article-title":"Sex differences in heart failure with preserved ejection fraction pathophysiology: a detailed invasive hemodynamic and echocardiographic analysis","volume":"7","author":"Beale","year":"2019","journal-title":"JACC Heart Fail"},{"key":"10.1016\/j.amjcard.2023.02.005_bib0032","doi-asserted-by":"crossref","first-page":"3859","DOI":"10.1093\/eurheartj\/ehz835","article-title":"Sex differences in heart failure","volume":"40","author":"Lam","year":"2019","journal-title":"Eur Heart J"},{"key":"10.1016\/j.amjcard.2023.02.005_bib0033","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1093\/eurheartj\/ehy590","article-title":"Outcomes of transcatheter mitral valve replacement for degenerated bioprostheses, failed annuloplasty rings, and mitral annular calcification","volume":"40","author":"Yoon","year":"2019","journal-title":"Eur Heart J"}],"container-title":["The American Journal of Cardiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0002914923000826?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0002914923000826?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T06:45:52Z","timestamp":1757573152000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0002914923000826"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4]]},"references-count":33,"alternative-id":["S0002914923000826"],"URL":"https:\/\/doi.org\/10.1016\/j.amjcard.2023.02.005","relation":{},"ISSN":["0002-9149"],"issn-type":[{"type":"print","value":"0002-9149"}],"subject":[],"published":{"date-parts":[[2023,4]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Sex Differences in Extensive Mitral Annular Calcification With Associated Mitral Valve Dysfunction","name":"articletitle","label":"Article Title"},{"value":"The American Journal of Cardiology","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.amjcard.2023.02.005","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2023 Elsevier Inc. All rights reserved.","name":"copyright","label":"Copyright"}]}}