Myocardial and Vascular Involvement in Patients with Takayasu Arteritis: A Cardiovascular MRI Study
Abstract
:1. Introduction
2. Material and Methods
2.1. Study Population
2.2. Cardiac MRI Imaging
- Severe aortic regurgitation: defined based on the guidelines regarding valvular heart diseases [14];
- Aortic aneurysms and aortic dissection: extracted from the patient’s computed tomography angiography (CTA) reports;
- Main pulmonary artery aneurysms: registered based on the patient’s CTA and CMR findings.
2.3. Major Adverse Cardiac and Cerebrovascular Events at Follow-Up
- Death: based on a telephone follow-up of the patient;
- Myocardial infarction (MI): based on the patient’s telephone follow-up and medical records;
- Aortic dissection: based on the patient’s aortic CTA results;
- Pulmonary thromboembolism: diagnosed based on the patient’s pulmonary CTA results;
- Cerebrovascular accident (CVA) and transient ischemic attack (TIA): diagnosed according to the diagnostic guideline of the American Academy of Neurology [15];
- Coronary artery bypass graft surgery: based on the availability of the patient’s surgical records and files.
2.4. Disease Activity Criteria and Corticosteroid Use
2.5. Statistical Analysis
3. Results
3.1. CMR Findings
3.2. Clinical, Laboratory, and Treatment Data
3.3. Follow-Up Results
4. Discussion
5. Limitations
6. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Patient (n = 37) | Control (n = 28) | p-Value | ||
---|---|---|---|---|
Male | 12 (32.4) | 14 (50.0) | 0.1 | |
Female | 25 (67.6) | 14 (50.0) | ||
Age y mean (SD) | 36 (16) | 31 (4) | 0.4 | |
Hypertension n (%) | 6 (16.2) | 0 (0) | - | |
Diabetes n (%) | 1 (2.7) | 0 (0) | - | |
Smoking | 2 (5.4) | 0 (0) | - | |
Dyslipidemia | 3 (8) | 0 (0) | - | |
ESR mean (SD) † | 39 (30) | 3 (1) | <0.001 | |
LVEF % mean (SD) † | 51 (9) | 58 (1.7) | <0.001 | |
Strain Parameters mean (SD) | ||||
LVGLS † | 13.70 (3.27) | 18.08 (1.35) | <0.001 | |
LVGCS | 17.44 (3.95) | 18.69 (2.18) | 0.1 | |
LVGRS | 42.54 (15.37) | 39.83 (7.78) | 0.3 | |
General characteristics of the Takayasu arteritis patients | ||||
Characteristics | Variable | Number | Variable | Number |
Signs and Symptoms at Presentation n (%) | Dyspnea | 21 (56.7) | Chest pain | 14 (37.8) |
Fatigue | 14 (37.8) | Upper-extremity blood pressure difference | 12 (32.4) | |
Palpitations | 6 (16.2) | Visual field defects | 4 (10.8) | |
Number of the Affected Major Aortic Branches at Presentation n (%) | No involvement | 13 (35.1) | 1 Affected vessel | 7 (18.9) |
2 Affected vessels | 7 (18.9) | ≥3 Affected vessels | 10 (27) | |
Affected Major Aortic Branches at Presentation (n %) | Left subclavian | 16 (43.2) | Right subclavian | 11 (29.7) |
Left common carotid | 9 (24.3) | Right common carotid | 6 (16.2) | |
Superior mesenteric | 6 (16.2) | Left or right renal | 6 (16.2) | |
Celiac trunk | 5 (13.5) | Brachiocephalic | 2 (5.4) | |
Presence of Aortic Wall Thickening | Thickened | 37 (100) | Normal | 0 |
Aortic Mural Edema * at Presentation n (%) | Positive | 34 (92) | Negative | 4 (11) |
Aortic Hyperenhancement ¥ at Presentation n (%) | Positive | 36 (97.3) | Negative | 1 (2.7) |
Myocardial Subepicardial and Mid-Wall Fibrosis ¥ at Presentation n (%) | Positive | 6 (16.3) | Negative | 31 (83.7) |
ACCCMR (%) | DCM | 1 (2.7) | Main PA aneurysm | 1 (2.7) |
LPA stenosis | 1 (2.7) | Myocarditis | 6 (16.2) | |
Severe AR | 2 (5.4) | Aortic dissection | 1 (2.7) | |
Ascending aorta aneurysm | 1 (2.7) | |||
MACCE at Follow-Up n (%) | CVA | 5 (13.5) | PTE | 1 (2.7) |
TIA | 1 (2.7) | CABG | 2 (5.4) |
ACCCMR (at the Time of CMR) | MACCE (at Follow-Up) | |||||
---|---|---|---|---|---|---|
Variable | Mean ± SD with ACCCMR | Mean ± SD without ACCCMR | p | Mean ± SD with MACCE | Mean ± SD without MACCE | p |
LVEF | 47.72 ± 11.49 | 52.52 ± 7.05 | 0.1 | 49.11 ± 12.22 | 51.39 ± 7.92 | 0.5 |
LVGLS | 12.08 ± 3.54 | 14.57 ± 2.82 | 0.02 | 11.61 ± 3.81 | 14.37 ± 2.84 | 0.02 |
LVGCS | 15.47 ± 4.10 | 18.51 ± 3.50 | 0.02 | 15.55 ± 5.79 | 18.05 ± 3.04 | 0.2 |
LVGRS | 35.9 ± 15.51 | 46.12 ± 14.36 | 0.05 | 37.19 ± 20.58 | 44.26 ± 13.30 | 0.2 |
Age | 35.85 ± 13.78 | 36.29 ± 17.52 | 0.9 | 42.89 ± 9.35 | 33.97 ± 17.32 | 0.1 |
ESR | 42.83 ± 34.28 | 27.84 ± 26.69 | 0.1 | 29.25 ± 33.29 | 35.17 ± 29.72 | 0.6 |
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Almasi, S.; Asadian, S.; Hosseini, L.; Rezaeian, N.; Ghasemi asl, S.; Ranjbar, A.; Sadat-Ebrahimi, S.-R.; Mahmoodieh, B.; Salmanipour, A. Myocardial and Vascular Involvement in Patients with Takayasu Arteritis: A Cardiovascular MRI Study. Diagnostics 2023, 13, 3575. https://doi.org/10.3390/diagnostics13233575
Almasi S, Asadian S, Hosseini L, Rezaeian N, Ghasemi asl S, Ranjbar A, Sadat-Ebrahimi S-R, Mahmoodieh B, Salmanipour A. Myocardial and Vascular Involvement in Patients with Takayasu Arteritis: A Cardiovascular MRI Study. Diagnostics. 2023; 13(23):3575. https://doi.org/10.3390/diagnostics13233575
Chicago/Turabian StyleAlmasi, Simin, Sanaz Asadian, Leila Hosseini, Nahid Rezaeian, Shakiba Ghasemi asl, Abdolmohammad Ranjbar, Seyyed-Reza Sadat-Ebrahimi, Behnaz Mahmoodieh, and Alireza Salmanipour. 2023. "Myocardial and Vascular Involvement in Patients with Takayasu Arteritis: A Cardiovascular MRI Study" Diagnostics 13, no. 23: 3575. https://doi.org/10.3390/diagnostics13233575