Thoracic aorta evaluation in patients with Takayasu's arteritis by transesophageal echocardiography.

BACKGROUND

There is no detailed description of thoracic aorta abnormalities assessed by transesophageal echocardiography (TEE) in patients with Takayasu's arteritis (TA). We aimed to evaluate these features in a series of patients in the chronic stage of TA.

METHODS

Fourteen patients (13 women, mean age 30 years) with inactive chronic TA were studied by TEE, and compared with 14 matched patients without aortic disease defined by TEE, who served as control subjects. In each segment of the thoracic aorta (ascending, arch, proximal, and distal descending aorta), we analyzed: (1) wall thickness; (2) diastolic diameters; and (3) systolic expansion index as a percentage of aortic expansibility.

RESULTS

Increased circumferential wall thickness (71% of 55 aortic segments studied) and dilated segments (37%) were observed in patients with TA, with significant higher values than control subjects (P < .05). A global impairment of the elastic properties of the thoracic aorta of patients with TA was noted in 85% of the analyzed segments, expressed by a significant reduction of the systolic expansion index (3.9 +/- 3.8%) as compared with control subjects (14 +/- 5.7%; P < .005).

CONCLUSIONS

TA as assessed by TEE is characterized by a remodeling process of the thoracic aorta with a marked and global decrease of aortic distensibility and concentric wall thickening. These features may be useful for noninvasive diagnosis of the chronic stage of TA by TEE.