{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T09:00:15Z","timestamp":1790586015368,"version":"4.1.0"},"reference-count":27,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T00:00:00Z","timestamp":1787875200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T00:00:00Z","timestamp":1787875200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Echocardiography"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Mitral annular calcification (MAC) is associated with atrial fibrillation and diastolic dysfunction, but its relationship with left atrial (LA) mechanics is poorly defined. The ratio of E\/e\u2032 to LA reservoir strain (LASr) is a non\u2010invasive surrogate of, not a direct measure of, LA stiffness. We assessed MAC and its severity against LASr and this LA stiffness index (LASI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this single\u2010center cross\u2010sectional study with prospective recruitment, 112 adults in sinus rhythm with ejection fraction \u226550% (58 with MAC, 54 age\u2010 and sex\u2010similar controls) underwent two\u2010dimensional speckle\u2010tracking echocardiography. MAC was graded mild to severe; LASI was calculated as E\/e\u2032 divided by LASr.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      LASr was lower (23.2 \u00b1 7.8%\u00a0vs. 26.7 \u00b1 7.7%,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.018) and LASI higher (0.57 \u00b1 0.30\u00a0vs. 0.34 \u00b1 0.20,\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001) in the MAC group. In models excluding the index components, MAC severity was independently associated with higher LASI (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      = 0.41,\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001) and MAC presence with lower LASr (\u22123.6 points,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.016). After clinical adjustment, each 0.1\u2010unit LASI increase was associated with MAC (odds ratio 1.71, 95% CI[1.34\u20132.17]). LASI discriminated MAC with an area under the curve of 0.762 (0.674\u20130.851; cut\u2010off 0.31, sensitivity 79%, specificity 63%), which did not differ from E\/e\u2032 (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.52) or LA volume index (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.48).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>MAC and its severity were associated with impaired LA reservoir function and a higher non\u2010invasive stiffness index. The index did not discriminate MAC better than its simpler components, so these cross\u2010sectional findings are hypothesis\u2010generating.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/echo.70608","type":"journal-article","created":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T03:01:15Z","timestamp":1787972475000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Mitral Annular Calcification and Its Severity in Relation to Left Atrial Reservoir Strain and a Non\u2010Invasive Left Atrial Stiffness Index"],"prefix":"10.1111","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-5034-1543","authenticated-orcid":false,"given":"Muhammed Ali","family":"\u015eahin","sequence":"first","affiliation":[{"name":"Department of Cardiology Cankiri State Hospital  Cankiri 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