Association Between Mitral Annular Calcification and Ventricular Tachycardia in Patients with Reduced and Mildly Reduced Ejection Fraction

<b>Objective:</b> This study aimed to evaluate the association between mitral annular calcification (MAC) and ventricular tachycardia (VT) in patients with reduced and mildly reduced ejection fraction and to identify independent predictors of VT. <b>Materials and Methods</b>: A total of 143 patients with heart failure and left ventricular ejection fraction (LVEF) under 50% were included in this retrospective cross-sectional study. Patients were classified into two groups according to the presence of VT. Clinical, biochemical, and echocardiographic variables were compared between groups. Independent predictors of VT were identified using multivariable logistic regression analysis. <b>Results:</b> MAC was significantly more prevalent in the VT group compared with controls (43.6% vs. 17.4%, <i>p</i> < 0.001) and was the strongest independent predictor of VT (OR: 2.74; 95% CI: 1.13-6.65; <i>p</i> = 0.026). Higher inflammatory activity, lower serum albumin levels, increased left atrial volume, renal dysfunction, and elevated diastolic filling pressures were also associated with VT. <b>Conclusions</b>: MAC is a strong and independent predictor of ventricular tachycardia in patients with reduced and mildly reduced ejection fraction. Incorporating MAC into the overall arrhythmic risk profile alongside inflammatory, metabolic, and structural parameters may improve risk stratification in this population.