Division of Cardiology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Int J Cardiol. 2012 Aug 9;159(1):14-20. doi: 10.1016/j.ijcard.2011.01.094. Epub 2011 Feb 26.
Takayasu's arteritis (TA) is primary vasculitis. Cardiac involvements in TA is due to the consequences of the vascular lesions as well as the primary pathology of the heart. The disease activity of TA is known to influence the prognosis of TA. We hypothesized that the cardiovascular involvement of TA is related to the disease activity. We evaluated the cardiovascular manifestations of TA, and we assessed their relation to the disease activity of TA. Two hundred four patients were diagnosed with TA from September, 1994 to March, 2009 according to the diagnostic criteria of the 1990 American College of Rheumatology. Their clinical features and the laboratory, angiographic and echocardiographic findings were retrospectively reviewed. The group with active disease activity was defined as satisfying one of the following criteria: i) an elevated ESR or CRP level, ii) thickened arterial wall with mural enhancement on CT or MR angiography, and iii) carotidynia at the time of the initial diagnosis. One hundred thirty nine patients (69.2%) were classified as the active group. The cardiovascular signs and symptoms were not generally different between the active and inactive groups. The active TA patients had more frequent involvement of the ascending aorta and the aortic arch and its main branches than did the inactive group. The active group showed a higher incidence of significant aortic valve regurgitation and pulmonary hypertension, and a higher level of NT-proBNP. These findings suggest that disease activity plays an important role for the cardiovascular manifestations of TA. The TA patients with higher activity have more cardiovascular morbidity compared to the TA patients with low disease activity.
Takayasu 动脉炎(TA)是一种原发性血管炎。TA 中的心脏受累是由于血管病变的后果以及心脏的原发性病理学。TA 的疾病活动被认为会影响 TA 的预后。我们假设 TA 的心血管受累与疾病活动有关。我们评估了 TA 的心血管表现,并评估了它们与 TA 疾病活动的关系。1994 年 9 月至 2009 年 3 月,根据 1990 年美国风湿病学会的诊断标准,我们诊断了 204 例 TA 患者。回顾性分析了他们的临床特征、实验室、血管造影和超声心动图检查结果。将活动期疾病定义为满足以下标准之一:i)ESR 或 CRP 水平升高,ii)CT 或 MR 血管造影显示动脉壁增厚伴壁强化,iii)初诊时颈动脉痛。139 例(69.2%)患者被归类为活动组。活动组和非活动组的心血管症状和体征一般无差异。活动型 TA 患者的升主动脉和主动脉弓及其主要分支受累更频繁。活动组显示出更高的主动脉瓣反流和肺动脉高压的发生率,以及更高的 NT-proBNP 水平。这些发现表明疾病活动对 TA 的心血管表现起着重要作用。与疾病活动低的 TA 患者相比,活动度更高的 TA 患者有更多的心血管发病率。