Related Experiment Videos
Dilated cardiomyopathy in non-specific aortoarteritis
1Department of Cardiology, Institute of Postgraduate Medical Education and Research, Calcutta.
Insights
Dilated cardiomyopathy occurs in over 5% of Takayasu
Area of Science:
- Cardiology
- Rheumatology
- Vascular Medicine
Background:
- Takayasu arteritis is a rare inflammatory condition affecting large arteries.
- Dilated cardiomyopathy is a serious cardiac condition characterized by ventricular enlargement.
- The association between Takayasu arteritis and dilated cardiomyopathy is not well-documented.
Purpose of the Study:
- To investigate the prevalence of dilated cardiomyopathy in patients with Takayasu arteritis.
- To describe the clinical, hemodynamic, and angiographic features of these patients.
- To understand the potential impact of dilated cardiomyopathy on Takayasu arteritis prognosis.
Main Methods:
- Retrospective analysis of 195 Takayasu arteritis cases.
- Clinical evaluation, electrocardiography, chest X-ray, echocardiography, hemodynamic monitoring, angiography, and histopathology.
- Focus on patients diagnosed with dilated cardiomyopathy.
Main Results:
- 12 out of 195 (5.58%) Takayasu arteritis patients had dilated cardiomyopathy.
- Patients were young (mean age 17.25 years), predominantly female (1:11 ratio).
- Common symptoms included dyspnea, edema, and systemic features; hypertension was absent. Hemodynamic and angiographic findings indicated impaired left ventricular function and varying degrees of aortoarteritis.
Conclusions:
- Dilated cardiomyopathy is a significant, though underreported, complication of Takayasu arteritis.
- This cardiac involvement can influence the overall prognosis of patients with aortoarteritis.
- Further research is warranted to elucidate the underlying mechanisms and long-term outcomes.
Abstract:
Out of 195 cases of Takayasu's arteritis who presented in our institute between January 1988 and December 1997, 12 (5.58%) had dilated cardiomyopathy. Age of these patients ranged from 10 to 30 years (17.25 +/- 5.30 years) and male-female ratio was 1:11. All the cases had cardiovascular system features (dyspnoea, oedema, palpitation, angina, etc. but without hypertension), three had central nervous system features (headache, vomiting, convulsion etc.) and all had general systemic features like weight loss, malaise, fever, arthralgia etc. Electrocardiography, chest X-ray and echocardiographic findings were consistent with dilated cardiomyopathy. Haemodynamic findings showed raised left ventricular end-diastolic pressure and pulmonary capillary wedge pressure in all; raised pulmonary artery pressure, pulmonary vascular resistance, right ventricular pressure and right atrial pressure in 6, 6, 4 and 2 cases, respectively; reduced left ventricular peak systolic pressure in 10 cases but central aortic pressure and systemic vascular resistance in all the cases were within normal limits. Angiography showed type I, II and III involvement in 7 (majority), 3 and 2 cases, respectively. Coronary and pulmonary angiography were normal and left ventricular angiography showed poor left ventricular systolic function in all the cases. Histopathological study (on 3 autopsy cases) showed non-specific inflammation of myocardium with lymphocyte/mononuclear cell infiltration and normal coronary vessels. So, dilated cardiomyopathy in Takayasu's arteritis is not rare, though not much reported, and can influence the prognosis of aortoarteritis cases.