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大动脉炎的心脏洞察:活动期大动脉炎的超声心动图差异

Cardiac Insights in Takayasu's Arteritis: Echocardiographic Differences in Active Takayasu Arteritis.

作者信息

Luna-Alcala Santiago, Martínez-Martínez Laura Aline, Bermudez-Gonzalez Jorge Luis, Martinez-Dominguez Pavel, Silveira-Torres Luis H, Guerra Enrique C, Cabello-Ganem Aldo, Vera-Bustamante David, Espinola-Zavaleta Nilda

机构信息

Nuclear Cardiology Department, National Institute of Cardiology Ignacio Chavez, Mexico City, Mexico.

Rheumatology Department, National Institute of Cardiology Ignacio Chavez, Mexico City, Mexico.

出版信息

Echocardiography. 2025 Jun;42(6):e70229. doi: 10.1111/echo.70229.

Abstract

INTRODUCTION

Takayasu arteritis mainly affects the aorta and its main branches. Several clinometric tools have been proposed for the assessment of disease activity. Echocardiography is a noninvasive imaging method useful in the study of cardiovascular manifestations. This study aimed to describe the differences in echocardiographic parameters between conventional and new modalities in patients with Takayasu arteritis with disease activity according to three real-life clinical scales.

METHODS

A prospective observational study was designed with patients meeting the ACR/EULAR 2022 criteria for Takayasu arteritis and a rheumatology outpatient clinic at a cardiovascular disease referral center. Disease activity was measured via the Dabague-Reyes (DR) score, National Institutes of Health score, and Indian Takayasu arteritis activity score. All patients underwent echocardiographic evaluation with conventional and new modalities.

RESULTS

Fifty-two patients with a diagnosis of TAK were studied; 48 (92.3%) patients were female, with a mean age of 41 ± 17.6 years. Numano V classification was the most common (80%). Twenty-five patients had active disease according to any score, which was correlated with a significant reduction in tricuspid annular plane systolic excursion (TAPSE) (19.45 ± 1.9 mm), abnormal left ventricular (LV) end-diastolic diameter, abnormal deceleration time (DT), and abnormal left atrial (LA) volume.

CONCLUSIONS

Some conventional and novel echocardiographic parameters are associated with active BP. These alterations could add weight to the staging of disease activity. These echocardiographic findings may also be observed differently according to the clinical form of disease measurement. However, further studies are needed to confirm these differences via echocardiography.

摘要

引言

大动脉炎主要累及主动脉及其主要分支。已经提出了几种用于评估疾病活动度的临床测量工具。超声心动图是一种无创成像方法,对研究心血管表现很有用。本研究旨在根据三种实际临床量表描述大动脉炎活动期患者传统和新超声心动图模式之间参数的差异。

方法

设计了一项前瞻性观察性研究,纳入符合2022年美国风湿病学会/欧洲抗风湿病联盟大动脉炎标准的患者以及一家心血管疾病转诊中心的风湿病门诊患者。通过达巴盖-雷耶斯(DR)评分、美国国立卫生研究院评分和印度大动脉炎活动评分来测量疾病活动度。所有患者均接受了传统和新超声心动图模式的评估。

结果

研究了52例诊断为大动脉炎的患者;48例(92.3%)为女性,平均年龄41±17.6岁。沼野V型分类最为常见(80%)。根据任何一项评分,25例患者有疾病活动,这与三尖瓣环平面收缩期位移(TAPSE)显著降低(19.45±1.9mm)、左心室(LV)舒张末期内径异常、减速时间(DT)异常和左心房(LA)容积异常相关。

结论

一些传统和新的超声心动图参数与疾病活动相关。这些改变可能有助于疾病活动度分期。根据疾病测量的临床形式,这些超声心动图表现也可能有不同观察结果。然而,需要进一步研究通过超声心动图来证实这些差异。

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