Echocardiographic characteristics of pulmonary artery involvement in Takayasu arteritis

Jiang, Wei; Yang, Yuanhua; Lv, Xiuzhang; Li, Yidan; Ma, Zhanhong; Li, Jifeng

doi:10.1111/echo.13464

Cited by 20 publications

(17 citation statements)

References 19 publications

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“…Besides the aorta and its branches, the pulmonary arteries (PAs) are involved in TA. PAs have been reported to be involved in 6.9 to 80% of TA patients from different populations [3][4][5][6][7][8]. The stenosis, occlusion, or embolism of PAs can cause pulmonary hypertension (PH), perfusion defects, or even pulmonary infarction [9][10][11].…”

Section: Introductionmentioning

confidence: 99%

Involvement of the pulmonary arteries in patients with Takayasu arteritis: a prospective study from a single centre in China

Kong

et al. 2020

Arthritis Res Ther

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Background: Takayasu arteritis (TA) is a large vessel vasculitis that can involve pulmonary arteries (PAs). We studied multiple clinical characteristics related to pulmonary artery involvement (PAI) in TA patients. Methods: We enrolled 216 patients with TA from a large prospective cohort. PAI was assessed in each patient based on data from magnetic resonance angiography/computed tomography angiography. Pulmonary hypertension, cardiac function, and pulmonary parenchymal lesions were evaluated further in patients with PAI based on echocardiography, the New York Heart Association Functional Classification, and pulmonary computed tomography, respectively. These abnormalities related to PAI were followed up to evaluate treatment effects. Results: PAI was detected in 56/216 (25.93%) patients, which involved the pulmonary trunk, main PAs, and small vessels in the lungs. Among patients with PAI, 28 (50%) patients were accompanied by pulmonary hypertension, which was graded as 'severe' in 9 (16.07%), 'moderate' in 10 (17.86%), and mild in 9 (16.07%). Twenty-six (46.43%) patients showed advanced NYHA function (III, 20, 35.71%; IV, 6, 10.71%). Furthermore, 21 (37.50%) patients presented with abnormal pulmonary parenchymal lesions in the area corresponding to PAI (e.g. the mosaic sign, infarction, bronchiectasis). During follow-up, two patients died due to heart failure and pulmonary thrombosis. In the remaining patients, the abnormalities mentioned above improved partially after routine treatment. Conclusions: PAI is common in TA patients. PAI can cause pulmonary hypertension, cardiac insufficiency, and pulmonary parenchymal lesions, which worsen patients' prognosis.

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Section: Introductionmentioning

confidence: 99%

Involvement of the pulmonary arteries in patients with Takayasu arteritis: a prospective study from a single centre in China

Kong

et al. 2020

Arthritis Res Ther

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“…Pulmonary artery involvement in TA is seen up to 50.0% of patients [10]. In the study of Sharma et al with 44 TA patients, pulmonary artery involvement was seen in 14.3% of patients [11].…”

Section: Discussionmentioning

confidence: 93%

Imaging modalities used in diagnosis and follow-up of patients with Takayasu’s arteritis

Dinçer¹,

Kılıç²,

Erden³

et al. 2021

Turk J Med Sci

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Imaging modalities used in diagnosis and follow-up of patients with Takayasu's arteritis Abstract Background/aim: Takayasu's arteritis (TA) is a rare, large-vessel vasculitis of unknown etiology, affecting aortic arch and its main branches. Non-invasive imaging methods are frequently used in diagnosis and follow up in Takayasu's arteritis. Studies investigating optimal timing of follow up imaging are rare. This study is aimed to investigate the radiologic changes in vascular involvements of Takayasu's arteritis patients one year after diagnosis. Materials and methods: Database of our Vasculitis Center was analyzed retrospectively and 97 patients were included into the study. Demographic, clinical, radiological and therapeutic findings of patients were recorded. Patients with follow-up imaging after approximately one year of diagnosis were recruited into further analysis. Radiological changes and the effect of different immunosuppressive agents on vascular involvements were investigated. Results: Mean age and disease duration of patients were 43.0 and 9.0 years. The most commonly used imaging methods/modalities for the diagnosis of TA were computer tomography-angiography (CT-Ang) (58.8%), magnetic resonance-angiography (MR-Ang) (29.9%) and doppler ultrasonography (11.3%). Subclavian and common carotid arteries were the most frequently involved vessels. Fifty-three patients underwent followup imaging after one year of diagnosis and in 64% of patients same imaging method had been used. MR-Ang (62.3%) and CT-Ang (35.9%) were the most preferred followup imaging studies. Sixty-eight percent of patients had stable vascular involvement, 28% had progression and 4% had regression. No difference was found in radiological changes 3 regarding patients with usage of different immunosuppressive agents (p=0.634). There was no association between the change in serum acute phase reactants and radiological disease activity. Conclusion: The most commonly used imaging modality for the diagnosis of TA was CT-Ang whereas MR-Ang was the most preferred for follow-up. Almost 30% of TA patients in our Vasculitis center had progression at around one year concordant with previous literature. A follow up imaging at around one year of treatment, seems feasible in management of TA.

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“…However, the majority of recent studies on the TAK-related heart diseases are case reports, case series, or cross-sectional studies, and it lacks large sample, prospective and dynamic observational studies to determine the development of cardiac involvement and its risk factors. Echocardiography is a widely used noninvasive tool to evaluate heart structural disease and cardiac dysfunction in TAK patients [13,14].…”

Section: Introductionmentioning

confidence: 99%

Risk factors for the adverse cardiac outcomes in the patients with Takayasu’s arteritis.

Wang

Yan

et al. 2020

Preprint

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Background : This study was aimed to investigate the long-term cardiac outcomes and find out risk factors for the deterioration of cardiac structure and function in patients with Takayasu’s arteritis (TAK).Methods : One hundred and ninety-eight TAK patients were recruited in the Department of Rheumatology, Zhongshan Hospital, Fudan University from January 2012 to December 2017. The endpoint of observation was December 31, 2019. Patients were divided into normal, mild-moderate and severe subgroups based on the severity of structural and functional impairment of heart. Comparison of baseline characteristics and treatment among these three subgroups was conducted to identify the risk factors for adverse cardiac outcomes.Results : A total of 60.1% (119/198) of TAK patients exhibited heart involvement on echocardiography at baseline. 70.6% (84/119) and 79.8% (95/119) cases showed pathological valvular and atrioventricular abnormalities, respectively. 68.7% (136/198) of patients were followed up and the median follow-up duration was 28.6 (12.3-43.4) months. 42.7% (58/136) and 22.8% (31/136) of patients had progress in heart’s structure and function. Cox regression showed that serum TNF-α level (HR=1.028, p= 0.021), aortic regurgitation (HR=3.109, p<0.001) and ventricular hypertrophy (HR=2.090, p= 0.006) at baseline were risk factors for the deterioration of cardiac structure. The cases with serum TNF-α levels (≥8.1pg/ml), mild aortic regurgitation and ventricular hypertrophy at baseline had highest risk of structural progression at 83.4%. Using normal subgroup as a control, the deterioration of cardiac structure and function was the most severe in the severe subgroup, with hazard ratios of 16.2 (95% CI, 6.0-44.1, p < 0.001) and 9.0 (95% CI, 3.3-24.5, p<0.001), respectively. The deteriorating events typically occurred within 2 years after diagnosis.Conclusions : To find out if there is heart involvement and progress, it’s indispensable to regularly monitor the serum TNF-α level and cardiac structure in TAK patients during the long-term follow-up.

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Echocardiographic characteristics of pulmonary artery involvement in Takayasu arteritis

Cited by 20 publications

References 19 publications

Involvement of the pulmonary arteries in patients with Takayasu arteritis: a prospective study from a single centre in China

Involvement of the pulmonary arteries in patients with Takayasu arteritis: a prospective study from a single centre in China

Imaging modalities used in diagnosis and follow-up of patients with Takayasu’s arteritis

Risk factors for the adverse cardiac outcomes in the patients with Takayasu’s arteritis.

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