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Predictors of left ventricular dysfunction in patients with Takayasu's or giant cell aortitis

D H Pfizenmaier1, F O Al Atawi, Y Castillo

  • 1Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota 55905, USA.

Clinical and Experimental Rheumatology
|January 29, 2005
PubMed

Insights

Left ventricular systolic dysfunction (LVSD) affects 18% of patients with Takayasu

Area of Science:

  • Cardiology
  • Rheumatology
  • Vascular Inflammation

Background:

  • Left ventricular systolic dysfunction (LVSD) in Takayasu's or Giant Cell aortitis (TA/GCA) is rarely reported.
  • Potential causes include hemodynamic and immunologic factors, but predictors remain unknown.
  • This study investigates predictors in a large, angiographically characterized TA/GCA cohort.

Purpose of the Study:

  • To identify clinical and angiographic predictors of LVSD in patients with TA/GCA.
  • To estimate the incidence of LVSD in this population.
  • To differentiate between hemodynamic and inflammatory causes of LVSD.

Main Methods:

  • Retrospective analysis of 78 patients with angiographically confirmed TA/GCA.
  • Transthoracic echocardiography (TTE) was used to assess LVSD (defined as LVEF < 50%).
  • Reviewers blinded to clinical and angiographic data evaluated echocardiograms.

Main Results:

  • 18% (14/78) of patients had LVSD, with a mean LVEF of 37%.
  • LVSD was significantly associated with aortic arch involvement (43% vs 9%) and greater extent of aortic disease (median 2 vs 1 segment).
  • Hypertension and aortic regurgitation were not associated with LVSD.

Conclusions:

  • LVSD in TA/GCA is linked to aortic arch involvement and disease extent.
  • Hemodynamic factors like hypertension and aortic regurgitation do not predict LVSD.
  • Cardiac inflammation is likely the primary cause of LVSD in TA/GCA.
Abstract

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