Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Am J Med Sci. 2018 Oct;356(4):357-364. doi: 10.1016/j.amjms.2018.06.021. Epub 2018 Jun 30.
Takayasu arteritis (TA) can involve the aortic root or cardiac valves, resulting in hemodynamic disorders. In this study, we focused on the prevalence and clinical characteristics of TA patients with valve regurgitation.
We retrospectively assessed the clinical data in the electronic medical records of 1,069 consecutive patients with TA admitted to Fuwai Hospital from January 1992 to August 2017. We evaluated the valvular structure and function mainly by cardiac ultrasound.
Among the 1,069 patients, 373 (34.9%) had valve regurgitation. The female to male ratio was 4.8:1. The average age at symptom onset was 28.1 ± 10.6 years. The median duration from symptom onset to first hospitalization was 65.9 months. Of patients with valve involvement, 47.4% and 40.1% had a high erythrocyte sediment rate and C-reactive protein level, respectively, at the time of echocardiography. Most patients (69.7%) had aortic regurgitation, and nearly half had moderate to severe aortic regurgitation. A total of 38.8% of patients had aortic valve damage, and 23.3% had involvement of the ascending aorta. Most other valve insufficiency was mild, including mitral regurgitation in 39.1% of patients, tricuspid regurgitation in 34.6%, and pulmonary regurgitation in 11.8%. Valve stenosis was rare. Misdiagnosis of other cardiac diseases occurred in 13 patients.
Cardiac valve insufficiency is common in Chinese TA patients. Patients should undergo echocardiography once TA is diagnosed. In young women of reproductive age, TA should be considered when aortic regurgitation is detected.
Takayasu 动脉炎（TA）可累及主动脉根部或心脏瓣膜，导致血流动力学紊乱。本研究重点关注有瓣膜反流的 TA 患者的患病率和临床特征。
我们回顾性评估了 1992 年 1 月至 2017 年 8 月期间 1069 例连续 TA 患者的电子病历中的临床数据。我们主要通过心脏超声评估瓣膜结构和功能。
在 1069 例患者中，373 例（34.9%）有瓣膜反流。男女比例为 4.8:1。症状发作的平均年龄为 28.1±10.6 岁。从症状发作到首次住院的中位时间为 65.9 个月。在有瓣膜受累的患者中，47.4%和 40.1%在超声心动图时红细胞沉降率和 C 反应蛋白水平较高。大多数患者（69.7%）有主动脉瓣反流，近一半有中重度主动脉瓣反流。共有 38.8%的患者有主动脉瓣损害，23.3%的患者有升主动脉受累。大多数其他瓣膜关闭不全为轻度，包括 39.1%的患者有二尖瓣反流，34.6%的患者有三尖瓣反流，11.8%的患者有肺动脉瓣反流。瓣膜狭窄很少见。13 例患者存在其他心脏疾病的误诊。
中国 TA 患者中常见心脏瓣膜功能不全。诊断 TA 后，患者应行超声心动图检查。在生育年龄的年轻女性中，当发现主动脉瓣反流时，应考虑 TA。
