Cardiac valvular involvement of Takayasu arteritis.

Affiliation

Ren Y(1), Du J(2), Guo X(3), Liu O(4), Liu W(1), Qi G(5), Pan L(6).
Author information:
(1)Department of Cardiology, Beijing Anzhen Hospital, Beijing Lab for Cardiovascular Precision Medicine, Capital Medical University, Beijing, 100029, China.
(2)Department of Rheumatology and Immunology, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, China.
(3)Department of Interventional Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, China.
(4)Department of Cardiovascular Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, China.
(5)Pulmonary and Critical Care Division, Tufts Medical Center, Boston, MA, USA.
(6)Department of Rheumatology and Immunology, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, China. [Email]

Abstract

OBJECTIVE: This study aimed to investigate the imaging and serological features in Takayasu arteritis (TA) patients with valvular involvement and determine the relationship between them. METHOD: This is a retrospective single-center study enrolled 103 TA patients fulfilling the American College of Rheumatology criteria. An independent medical chart review was performed by two senior rheumatologists from Beijing Anzhen Hospital, Capital Medical University. The logistic analysis was used to investigate the relationship between valvular involvement in TA patients and the imaging and serological features of them. RESULTS: Sixty-six TA patients (64.08%) had cardiac valvular involvement in our study. Aortic insufficiency (62.12%) was the most common valvular involvement. Twelve (22.22%) patients developed heart failure. In patients with valvular involvement, the most common angiographic type was Numano type V, which was significantly higher than that in patients without valvular involvement (53.30% vs 32.43%, p = 0.044), followed by coronary involvement (28.79% vs 10.81%, p = 0.036) and Numano type IIb (21.21% vs 5.41%, p = 0.034). Serum levels of immunoglobulin A (2.84 ± 1.42 g/L vs 2.26 ± 0.97 g/L, p = 0.032) and immunoglobulin G (13.5 ± 4.71 g/L vs 11.42 ± 3.01 g/L, p = 0.015) were significantly higher in patients with valvular involvement. Numano type IIb is significantly related to moderate-severe aortic valvular regurgitation in TA patients (4.10 [1.03-16.33], p = 0.04). Elevated C-reactive protein (CRP) level is associated with moderate-severe mitral valve involvement in TA patients (p = 0.05, OR = 17.75, 95% CI 1.07-295.41). CONCLUSIONS: CRP elevation and Numano type IIb are significantly related to different types of valvular involvement in TA patients. Key Points • The Numano types IIb and V were common in TA patients with valvular involvement. • CRP elevation and Numano type IIb are close related to valvular involvement in TA patient. • Echocardiogram screening and CRP level examination are reasonable to TA patients which might have valvular involvement.