Department of Rheumatology and Immunology, Beijing Anzhen Hospital, Capital Medical University, 2 Anzhen Road, Chaoyang District, Beijing, China.
Department of Cardiovascular surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
BMC Cardiovasc Disord. 2020 Feb 3;20(1):52. doi: 10.1186/s12872-020-01364-w.
The etiology of Takayasu arteritis (TA) is unknown; however, a possible relationship between streptococcal infection and TA has been proposed. This study aimed to identify the clinical features and cardiac valvular involvement in untreated TA patients with an elevated antistreptolysin O (ASO) titer.
In this retrospective study, the clinical characteristics and features of valvular involvement were compared in TA patients with or without an elevated ASO titer.
Of the 74 untreated TA patients, 13 patients were found have elevated ASO titers (17.6%). Mitral insufficiency was the most common in patients with elevated ASO (69.2%, 9/13), followed by aortic valve insufficiency (46.2%, 5/13) and tricuspid insufficiency (46.2%, 5/13), which were no significantly different than that in normal ASO group. The proportions of moderate to severe mitral (30.8% vs 1.6%, p = 0.000) and tricuspid valve (15.4% vs 1.64%, p = 0.023) insufficiency in the ASO positive group were significantly higher than those in the ASO negative group. The odds of mitral regurgitation in patients with elevated ASO titers were 3.9 times higher than those in the group with normal ASO titers (p = 0.053, OR = 3.929, 95% confidence interval [CI]: 0.983-15.694). Furthermore, the risk of moderate to severe mitral insufficiency in patients with elevated ASO titers was 41.6 times higher than that in patients with normal ASO titers (p = 0.002, OR = 41.600, 95% CI: 3.867-447.559).
An increase in ASO titer is related to valvular involvement in TA and is closely linked to mitral insufficiency.
Takayasu 动脉炎（TA）的病因尚不清楚；然而，已经提出链球菌感染与 TA 之间可能存在关系。本研究旨在确定未经治疗的抗链球菌溶血素 O（ASO）滴度升高的 TA 患者的临床特征和心脏瓣膜受累情况。
在这项回顾性研究中，比较了 ASO 滴度升高和正常的 TA 患者的临床特征和瓣膜受累情况。
在 74 例未经治疗的 TA 患者中，发现 13 例患者 ASO 滴度升高（17.6%）。ASO 滴度升高的患者中最常见的是二尖瓣关闭不全（69.2%，9/13），其次是主动脉瓣关闭不全（46.2%，5/13）和三尖瓣关闭不全（46.2%，5/13），与 ASO 正常组无显著差异。ASO 阳性组中中度至重度二尖瓣（30.8%比 1.6%，p=0.000）和三尖瓣（15.4%比 1.64%，p=0.023）关闭不全的比例明显高于 ASO 阴性组。ASO 滴度升高患者的二尖瓣反流发生率是 ASO 滴度正常患者的 3.9 倍（p=0.053，OR=3.929，95%置信区间[CI]：0.983-15.694）。此外，ASO 滴度升高患者中中度至重度二尖瓣关闭不全的风险是 ASO 滴度正常患者的 41.6 倍（p=0.002，OR=41.600，95%CI：3.867-447.559）。
ASO 滴度升高与 TA 中的瓣膜受累有关，与二尖瓣关闭不全密切相关。
