Coronary CT angiography in Takayasu arteritis

Area of Science:

• Cardiovascular Imaging
• Rheumatology
• Vascular Medicine

Background:

• Takayasu arteritis is a large vessel vasculitis affecting the aorta and its branches, with potential coronary artery involvement.
• Coronary CT angiography is a valuable tool for visualizing coronary arteries and detecting various types of lesions.

Purpose of the Study:

• To characterize coronary artery involvement in patients with Takayasu arteritis using coronary CT angiography.
• To evaluate the presence and location of coronary artery lesions in symptomatic patients.

Main Methods:

• Contrast-enhanced 64-slice coronary CT angiography was performed on 18 patients with Takayasu arteritis and symptoms.
• Coronary artery lesions were classified using the Numano classification and evaluated for stenosis.
• Clinical presentations were analyzed in relation to coronary artery involvement detected by CT angiography.

Main Results:

• Coronary artery involvement was detected in 8 patients (44.4%), with 19 lesions identified, predominantly in ostial (13) and proximal (5) segments.
• Eight lesions (42.1%) showed >50% diameter reduction, located in ostial (2) and proximal (6) segments.
• Patients with coronary artery involvement had a significantly longer median disease duration (176 months) compared to those without (21 months) (p=0.013).

Conclusions:

• Coronary CT angiography is effective for assessing coronary artery involvement in Takayasu arteritis.
• The study confirms that coronary lesions in Takayasu arteritis are most common in ostial and proximal locations.
• Longer disease duration is a significant factor in patients with Takayasu arteritis who develop coronary artery involvement.