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Echocardiography conventionally is the first-line imaging modality for anatomic assessment, and evaluation of mitral valve function. Cardiac computed tomography (CT) has demonstrated importance as an imaging modality for the evaluation and planning of related procedures. It also holds promise in quantitative grading of MAC. Currently, there is no universally accepted definition or classification system of MAC severity. We review the multimodality imaging evaluation of MAC and associated valvular dysfunction and propose a novel classification system based on qualitative and quantitative measurements derived from echocardiography and cardiac CT. \u00a0<\/jats:p>","DOI":"10.1093\/ehjci\/jeab185","type":"journal-article","created":{"date-parts":[[2021,9,8]],"date-time":"2021-09-08T11:25:01Z","timestamp":1631100301000},"page":"e111-e122","source":"Crossref","is-referenced-by-count":48,"title":["Mitral annular calcification and valvular dysfunction: multimodality imaging evaluation, grading, and management"],"prefix":"10.1093","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2985-7468","authenticated-orcid":false,"given":"Bo","family":"Xu","sequence":"first","affiliation":[{"name":"Section of Cardiovascular Imaging, Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Sydell and Arnold Miller Family Heart, Vascular and Thoracic Institute, Cleveland Clinic, 9500 Euclid Avenue, Desk J1-5, Cleveland, OH 44195, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5547-0235","authenticated-orcid":false,"given":"Duygu","family":"Kocyigit","sequence":"additional","affiliation":[{"name":"Section of Cardiovascular Imaging, Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Sydell and Arnold Miller Family Heart, Vascular and Thoracic Institute, Cleveland Clinic, 9500 Euclid Avenue, Desk J1-5, Cleveland, OH 44195, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5570-9402","authenticated-orcid":false,"given":"Tom Kai Ming","family":"Wang","sequence":"additional","affiliation":[{"name":"Section of Cardiovascular Imaging, Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Sydell and Arnold Miller Family Heart, Vascular and Thoracic Institute, Cleveland Clinic, 9500 Euclid Avenue, Desk J1-5, Cleveland, OH 44195, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4486-7549","authenticated-orcid":false,"given":"Carmela D","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Anatomical Pathology, Cleveland Clinic, Cleveland, OH 44195, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E Rene","family":"Rodriguez","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Anatomical Pathology, Cleveland Clinic, Cleveland, OH 44195, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G\u00f6sta B","family":"Pettersson","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Sydell and Arnold Miller Family Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH 44195, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6844-073X","authenticated-orcid":false,"given":"Shinya","family":"Unai","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Sydell and Arnold Miller Family Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH 44195, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian P","family":"Griffin","sequence":"additional","affiliation":[{"name":"Section of Cardiovascular Imaging, Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Sydell and Arnold Miller Family Heart, Vascular and Thoracic Institute, Cleveland Clinic, 9500 Euclid Avenue, Desk J1-5, Cleveland, OH 44195, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,9,9]]},"reference":[{"key":"2022022217011637600_jeab185-B1","doi-asserted-by":"crossref","first-page":"619","DOI":"10.1016\/0002-8703(81)90229-5","article-title":"Mitral valve \"anular\" calcium forming a complete circle or \"O\" configuration: clinical and necropsy observations","volume":"101","author":"Roberts","year":"1981","journal-title":"Am Heart J"},{"key":"2022022217011637600_jeab185-B2","doi-asserted-by":"crossref","first-page":"718","DOI":"10.1016\/S0022-5223(96)70332-X","article-title":"Extensive calcification of the mitral valve anulus: pathology and surgical management","volume":"111","author":"Carpentier","year":"1996","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2022022217011637600_jeab185-B3","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1016\/j.ahj.2005.03.052","article-title":"Clinical significance of calcification of the fibrous skeleton of the heart and aortosclerosis in community dwelling elderly. 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