Yurdakul Selen, Alibaz-Öner Fatma, Direskeneli Haner, Aytekin Saide
Division of Cardiology, Florence Nightingale Hospital, İstanbul, Turkey.
Department of Rheumatology, Marmara University School of Medicine, İstanbul, Turkey.
Eur J Rheumatol. 2018 Mar;5(1):16-21. doi: 10.5152/eurjrheum.2017.16108. Epub 2017 Oct 25.
Takayasu's arteritis (TAK) is a chronic inflammatory vasculitis of the aorta and its major branches. In the present study, we aimed to evaluate the motion of the vascular wall and myocardial contractility by using a novel strain imaging method, velocity vector imaging (VVI), in patients with TAK. We also aimed to compare them with another inflammatory autoimmune disorder, systemic lupus erythematosus (SLE).
We studied 33 patients with TAK, 18 patients with SLE, and 20 age- and sex-matched controls. All participants were subjected to carotid artery Doppler ultrasonography and transthoracic echocardiographic evaluation. VVI analysis was also performed to assess subclinical left ventricular (LV) systolic dysfunction and to determine tissue motion of the common carotid arteries (CCAs).
Aortic strain and distensibility were significantly impaired in patients with TAK, while the aortic stiffness and carotid artery stiffness indexes were increased. Aortic distensibility was the only parameter that was decreased among SLE patients. The values of CCA peak longitudinal strain, strain rate, and total longitudinal displacement (TLD) were also impaired in patients with TAK. Peak radial velocity was decreased while time-to-peak radial velocity was increased. In the SLE group, peak longitudinal strain, strain rate, TLD, and peak radial velocity were impaired. LV longitudinal peak systolic strain and strain rate were reduced in patients with TAK. Similarly, we revealed impaired subclinical LV systolic function in patients with SLE.
VVI is a novel strain imaging technique with additional value to determine early impairment in vascular and myocardial wall motion in patients with TAK.
高安动脉炎(TAK)是一种累及主动脉及其主要分支的慢性炎症性血管炎。在本研究中,我们旨在运用一种新型应变成像方法——速度向量成像(VVI),评估TAK患者血管壁的运动及心肌收缩力。我们还旨在将其与另一种炎症性自身免疫性疾病——系统性红斑狼疮(SLE)进行比较。
我们研究了33例TAK患者、18例SLE患者以及20例年龄和性别匹配的对照者。所有参与者均接受了颈动脉多普勒超声检查和经胸超声心动图评估。还进行了VVI分析,以评估亚临床左心室(LV)收缩功能障碍,并确定颈总动脉(CCA)的组织运动情况。
TAK患者的主动脉应变和扩张性显著受损,而主动脉僵硬度和颈动脉僵硬度指数升高。主动脉扩张性是SLE患者中唯一降低的参数。TAK患者的CCA纵向峰值应变、应变率和总纵向位移(TLD)值也受损。径向峰值速度降低,而达到径向峰值速度的时间增加。在SLE组中,纵向峰值应变、应变率、TLD和径向峰值速度均受损。TAK患者的LV纵向峰值收缩应变和应变率降低。同样,我们发现SLE患者存在亚临床LV收缩功能障碍。
VVI是一种新型应变成像技术,对于确定TAK患者血管和心肌壁运动的早期损伤具有额外价值。