Mitral Stenosis: Beyond Rheumatic Disease | JACC Baran

Hosts Mitsuaki Sawano, MD, Kentaro Ejiri, MD, and Nobuhiro Ikemura, MD welcome Dr. Nahoko Kato, MD, PhD (Tokyo Bay Urayasu Ichikawa Medical Center) and Dr. Hiroyuki Okura, MD, PhD (Gifu University) to discuss their JACC study, “Mitral Annular Calcification-Related Mitral Stenosis: 5-Year Outcomes and Prognostic Determinants in the JAMAC Study.” Using multicenter Japanese data from the JAMAC Study, this episode explores why calcific mitral stenosis differs fundamentally from rheumatic mitral stenosis, with poorer 5-year survival and a striking burden of noncardiac death. The discussion highlights how MAC-related MS may reflect systemic degenerative and metabolic disease rather than an isolated valve problem, why mitral valve area may be more informative than transmitral gradient for risk stratification, and what future prospective studies may reveal about progression, intervention, and patient selection.