Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Blood Press. 2022 Dec;31(1):146-154. doi: 10.1080/08037051.2022.2091513.
Takayasu arteritis (TA) is a rare disease, which is frequently misdiagnosed or its diagnosis can be missed. This study aimed to analyse the characteristics of four-limb blood pressure (4LBP) and brachial-ankle pulse wave velocity (baPWV) in patients with TA, which could be useful in disease detection. We consecutively enrolled 182 patients with TA at Fuwai Hospital between January 2013 and January 2016. Pulse pressure (PP), pulsatile index (PI), inter-arm systolic blood pressure (SBP) difference (IASBPD), inter-leg SBP difference (ILSBPD), ankle-brachial index (ABI), baPWV, and inter-side baPWV difference (ΔbaPWV) were analysed and compared with those of age-, sex-, and SBP-matched participants without cardiovascular diseases. In the TA group, the diastolic blood pressure was lower (67.4 ± 23.7 vs 84.1 ± 15.0 mmHg), PP was larger (69.7 ± 23.6 vs 53.7 ± 10.6 mmHg), PI was higher (1.3 ± 2.1 vs. 0.6 ± 0.1 mmHg), IASBPD was larger (18.2 ± 24.1 vs 4.2 ± 3.3 mmHg), and ILSBPD was larger (10.7 ± 15.0 vs 5.3 ± 4.1 mmHg) than those of the controls (all < 0.01). Moreover, the proportions of PP >70 mmHg (36.8% vs 4.4%), PI > 1.0 (40.1% vs 2.2%), IASBPD >15 mmHg (34.6% vs. 0%), highest ABI >1.4 (17.6% vs. 0%), ILSBPD >15 mmHg (14.8% vs. 3.3%), lowest ABI < 0.9 (24.7% vs 2.2%), and ΔbaPWV > 185 cm/s (28.6% vs. 1.1%) were significantly greater in the TA group than in the control group (all < 0.01). Approximately 80.8% of patients with TA (vs. 10.4% of controls) presented with at least one of these seven parameters ( = 0.000). The characteristics of 4LBP and baPWV in most patients with TA were abnormal, which helped us perform non-invasive primary screening and comprehensive evaluation of vascular lesions in such patients.
Takayasu 动脉炎(TA)是一种罕见的疾病,常被误诊或漏诊。本研究旨在分析 TA 患者四肢血压(4LBP)和肱踝脉搏波速度(baPWV)的特征,这有助于疾病的早期发现。我们连续纳入 2013 年 1 月至 2016 年 1 月期间在阜外医院就诊的 182 例 TA 患者。分析并比较了 TA 患者与年龄、性别、收缩压匹配的无心血管疾病参与者的脉压(PP)、脉动指数(PI)、臂间收缩压差异(IASBPD)、腿间收缩压差异(ILSBPD)、踝臂指数(ABI)、baPWV 和双侧 baPWV 差异(ΔbaPWV)。在 TA 组,舒张压较低(67.4±23.7 比 84.1±15.0mmHg),PP 较大(69.7±23.6 比 53.7±10.6mmHg),PI 较高(1.3±2.1 比 0.6±0.1mmHg),IASBPD 较大(18.2±24.1 比 4.2±3.3mmHg),ILSBPD 较大(10.7±15.0 比 5.3±4.1mmHg)(均 P<0.01)。此外,PP>70mmHg(36.8%比 4.4%)、PI>1.0(40.1%比 2.2%)、IASBPD>15mmHg(34.6%比 0%)、ABI 最高值>1.4(17.6%比 0%)、ILSBPD>15mmHg(14.8%比 3.3%)、ABI 最低值<0.9(24.7%比 2.2%)、双侧 baPWV 差异>185cm/s(28.6%比 1.1%)的比例在 TA 组均显著高于对照组(均 P<0.01)。大约 80.8%的 TA 患者(比对照组的 10.4%)至少有一个参数异常(=0.000)。大多数 TA 患者的 4LBP 和 baPWV 特征异常,有助于对患者进行血管病变的非侵入性初步筛查和综合评估。