Catastrophic Cardiac Complications of Takayasu’s Arteritis

Godil, Sara; Saqi, Bilal; Godil, Kareem; Sabzwari, Syed Rafay Ali; Rajeswaran, Yasotha

doi:10.7759/cureus.9142

Cited by 3 publications

(2 citation statements)

References 13 publications

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“…And more than half of them (58.0%, 51/88) were moderate to severe AR, indicating that the damage of aortic valve is serious caused by TAK, which reminded clinicians to early intervention. It is believed that the most common cardiac manifestation of TAK is AR, which could lead to myocardial remodeling and left ventricle dysfunction [ 24 ], and is considered a significant risk factor for mortality in patients with TAK [ 20 , 25 – 27 ].…”

Section: Discussionmentioning

confidence: 99%

Risk factors and surgical prognosis in patients with aortic valve involvement caused by Takayasu arteritis

Shi

et al. 2022

Arthritis Res Ther

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Objective Aortic valve involvement is not uncommon in patients with Takayasu arteritis (TAK) and leading to poor prognosis. The aim of our study was to explore the risk factors of aortic valve involvement and to evaluate the prognosis in TAK patients with aortic valve involvement. Method In this retrospective study, 172 TAK patients were divided into groups with or without aortic valve involvement to identify the risk factors. Patients who underwent aortic valve surgical treatment were followed up to assess cumulative incidence of postoperative adverse events. Results A total of 92 TAK patients (53.49%) had aortic valvular lesion. The infiltration of inflammatory cells was found in surgical specimens of aortic valve. Numano type IIb, elevated high-sensitivity C-reactive protein (hs-CRP) level, and dilation of ascending aorta and aortic root were statistically associated with aortic valvular lesion in TAK patients (OR [95%CI] 6.853 [1.685–27.875], p=0.007; 4.896 [1.646–14.561], p=0.004; 4.509 [1.517–13.403], p=0.007; 9.340 [2.188–39.875], p=0.003). The 1-, 5-, and 7-year cumulative incidence of postoperative adverse events were 14.7%, 14.7%, and 31.8%, respectively. Surgical methods (p=0.024, hazard ratio (HR) 0.082) and postoperatively anti-inflammatory therapy (p=0.036, HR 0.144) were identified as potential predictors of postoperative adverse events. Conclusions Regularly echocardiogram screening is suggested in patients with Numano type IIb and aggressive treatment should be performed early in TAK patients. As for TAK patients with aortic valve surgery, aortic root replacement seems to be the preferred option and regular anti-inflammatory therapy may reduce the occurrence of adverse events of them.

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Section: Discussionmentioning

confidence: 99%

Risk factors and surgical prognosis in patients with aortic valve involvement caused by Takayasu arteritis

Shi

et al. 2022

Arthritis Res Ther

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“…The main pathological manifestations of TA are irregular thickening of aortic wall, proliferation of endothelial cells, fibrosis, and contraction of media and adventitia, accompanied by various types of inflammation, such as acute exudative inflammation, chronic non-specific inflammation, and various granulomatous inflammations (10). The pathological manifestations of different stages are different: the early inflammatory process involves all layers of the vascular wall, showing the accumulation of inflammatory cells, such as lymphocytes (11,12), the middle stage shows the intimal hyperplasia of the arterial wall and the progress of the inflammatory process of the media and adventitia, and the end stage shows the diffuse or nodular fibrosis of perivascular tissue, followed by narrowing of the lumen (13)(14)(15).…”

Section: Discussionmentioning

confidence: 99%

A Case Report: An Elderly Male Patient With Takayasu Arteritis After Coronary Artery Bypass Grafting

Liu

Zhang

et al. 2021

Front. Cardiovasc. Med.

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Background: Takayasu arteritis is a rare chronic granulomatous inflammation involving the aorta and its main branches. In this report, we describe an extremely rare elderly male patient with Takayasu arteritis (TA) after coronary artery bypass grafting (CABG).Case Summary: A 61-year-old male patient with persistent precordial pain underwent angiography. Vascular murmurs could be heard in carotid artery and bilateral renal artery by auscultation. Laboratory parameters showed high Erythrocyte Sedimentation Rate (ESR) and C-reactive protein (CRP). CT coronary angiography showed multiple stenoses of aorta and its main branches, such as carotid and renal artery involvement. Coronary angiography showed that the coronary artery had multiple branch stenoses, the left anterior descending artery (LAD) had severe stenosis, the distal end of which was reversed to the right coronary artery (RCA), and the RCA was completely occluded. Because of the high level of markers of inflammatory activity, the patient began to take glucocorticoid. Although the patient still had multibranch stenosis of coronary artery, considering the previous CABG operation history, surgery, and interventional therapy of the patient were not feasible, the patient was given conservative drug for further treatment. After treatment, the inflammatory index was significantly descended, and N terminal-pro Brain natriuretic peptide (NT-pro BNP) was decreased.Discussion: A rare case of an elderly male patient with Takayasu arteritis after coronary artery bypass grafting was reported. In addition to hypertension, hyperlipidemia, and other risk factors, coronary artery involvement caused by TA may be a major cause of aggravation of symptoms in patients with acute myocardial infarction (AMI), especially after CABG.

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New Presentation of Takayasu Arteritis in a Patient With Preexisting Ulcerative Colitis

Smith,

Meschino,

Gold

2024

AIM Clinical Cases

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Catastrophic Cardiac Complications of Takayasu’s Arteritis

Cited by 3 publications

References 13 publications

Risk factors and surgical prognosis in patients with aortic valve involvement caused by Takayasu arteritis

Risk factors and surgical prognosis in patients with aortic valve involvement caused by Takayasu arteritis

A Case Report: An Elderly Male Patient With Takayasu Arteritis After Coronary Artery Bypass Grafting

New Presentation of Takayasu Arteritis in a Patient With Preexisting Ulcerative Colitis

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