Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, South-1, West-16, Chuo-ku, Sapporo, 060-8543, Japan.
Division of Rehabilitation, Sapporo Medical University Hospital, Sapporo, Japan.
ESC Heart Fail. 2019 Aug;6(4):894-897. doi: 10.1002/ehf2.12487. Epub 2019 Jul 11.
Takayasu arteritis (TA) is a large vessel vasculitis of unknown aetiology characterized by chronic inflammatory changes of the aorta and its major branches. We report the active TA case who had severe heart failure due to acute myocardial infarction and aortic regurgitation. Bentall procedure was successfully performed, but he had severely depressed left ventricular function and muscle wasting together with vascular inflammation. The treatment with tocilizumab, an interleukin-6 receptor monoclonal antibody, in addition to prednisolone and standard heart failure therapy led to prompt remission of TA activity and improvement of left ventricular function and muscle wasting. Taken together with possible involvement of interleukin-6 in the pathogenesis of heart failure and muscle wasting, inhibition of interleukin-6 receptor signalling by tocilizumab may be a safe and reasonable approach in the treatment of active TA with heart failure and muscle wasting.
Takayasu 动脉炎（TA）是一种病因不明的大血管炎，其特征为主动脉及其主要分支的慢性炎症性改变。我们报告了一例活动期 TA 病例，该患者因急性心肌梗死和主动脉瓣反流导致严重心力衰竭。成功进行了 Bentall 手术，但他的左心室功能严重降低，伴有肌肉萎缩和血管炎症。除了泼尼松龙和标准心力衰竭治疗外，加用白细胞介素-6 受体单克隆抗体托珠单抗治疗，迅速缓解了 TA 活动，并改善了左心室功能和肌肉萎缩。白细胞介素-6 可能参与心力衰竭和肌肉萎缩的发病机制，因此，托珠单抗抑制白细胞介素-6 受体信号可能是治疗心力衰竭和肌肉萎缩的活动期 TA 的一种安全合理的方法。
