Affected Microcirculation and Vascular Hemodynamics in Takayasu Arteritis

Area of Science:

• Vascular Medicine
• Rheumatology
• Cardiology

Background:

• Takayasu arteritis (TAK) is a rare inflammatory condition affecting the aorta and its branches.
• While ultrasound detects arterial wall inflammation, microcirculation and hemodynamics in TAK are less understood.

Purpose of the Study:

• To investigate if skin microcirculation and cerebrovascular hemodynamics provide additional insights into vascular disease in TAK patients.
• To assess microcirculatory oxygen saturation, cerebrovascular reserve capacity, and arterial stiffness in TAK.

Main Methods:

• 17 TAK patients and 17 controls underwent laser Doppler flowmetry/diffuse reflectance spectroscopy for skin oxygen saturation (OxyP).
• Transcranial Doppler (TCD) assessed cerebrovascular reserve capacity (CVR).
• Applanation tonometry measured radial artery pulse waves for augmentation index (AIx75); ultrasound assessed intima-media thickness (IMT) and stenosis.

Main Results:

• TAK patients exhibited reduced skin OxyP (79% vs. 87%, p<0.001) and increased AIx75 (22.3 vs. 9.2, p=0.01) irrespective of stenosis.
• No significant differences in CVR were observed between groups.
• Signs of higher resistance flow were noted in the middle cerebral artery in TAK patients.

Conclusions:

• Impaired skin microcirculation and preserved CVR are characteristic of TAK, independent of significant arterial stenosis.
• Evidence of increased arterial stiffness in central and cerebral arteries was observed in TAK patients.
• Further research is needed to determine the predictive value of these findings for cardiovascular events.