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Cardiac Insights in Takayasu's Arteritis: Echocardiographic Differences in Active Takayasu Arteritis
Santiago Luna-Alcala1, Laura Aline Martínez-Martínez2, Jorge Luis Bermudez-Gonzalez3
1Nuclear Cardiology Department, National Institute of Cardiology Ignacio Chavez, Mexico City, Mexico.
Insights
Echocardiography reveals significant changes in active Takayasu arteritis (TA). Reduced tricuspid annular plane systolic excursion (TAPSE) and abnormal left ventricular and atrial parameters indicate disease activity in TA patients.
Area of Science:
- Cardiology
- Rheumatology
- Medical Imaging
Background:
- Takayasu arteritis (TA) primarily affects the aorta and its branches.
- Assessing TA disease activity is crucial, with several clinometric tools available.
- Echocardiography offers a noninvasive method to evaluate cardiovascular manifestations in TA.
Purpose of the Study:
- To compare conventional and novel echocardiographic parameters in Takayasu arteritis patients with active disease.
- To correlate echocardiographic findings with disease activity assessed by three real-life clinical scales.
Main Methods:
- A prospective observational study included patients meeting ACR/EULAR 2022 criteria for Takayasu arteritis.
- Disease activity was assessed using Dabague-Reyes (DR) score, NIH score, and Indian TA activity score.
- All patients underwent comprehensive echocardiographic evaluations using conventional and advanced modalities.
Main Results:
- Fifty-two TA patients (92.3% female, mean age 41) were studied; 80% had Numano V classification.
- Twenty-five patients exhibited active disease based on clinical scores.
- Active disease correlated with reduced tricuspid annular plane systolic excursion (TAPSE), abnormal left ventricular end-diastolic diameter, abnormal deceleration time (DT), and abnormal left atrial (LA) volume.
Conclusions:
- Conventional and novel echocardiographic parameters are linked to active Takayasu arteritis.
- These echocardiographic alterations may aid in staging disease activity.
- Further research is necessary to validate these echocardiographic findings and their variations across different clinical disease measurements.
Introduction:
Takayasu arteritis mainly affects the aorta and its main branches. Several clinometric tools have been proposed for the assessment of disease activity. Echocardiography is a noninvasive imaging method useful in the study of cardiovascular manifestations. This study aimed to describe the differences in echocardiographic parameters between conventional and new modalities in patients with Takayasu arteritis with disease activity according to three real-life clinical scales.
Methods:
A prospective observational study was designed with patients meeting the ACR/EULAR 2022 criteria for Takayasu arteritis and a rheumatology outpatient clinic at a cardiovascular disease referral center. Disease activity was measured via the Dabague-Reyes (DR) score, National Institutes of Health score, and Indian Takayasu arteritis activity score. All patients underwent echocardiographic evaluation with conventional and new modalities.
Results:
Fifty-two patients with a diagnosis of TAK were studied; 48 (92.3%) patients were female, with a mean age of 41 ± 17.6 years. Numano V classification was the most common (80%). Twenty-five patients had active disease according to any score, which was correlated with a significant reduction in tricuspid annular plane systolic excursion (TAPSE) (19.45 ± 1.9 mm), abnormal left ventricular (LV) end-diastolic diameter, abnormal deceleration time (DT), and abnormal left atrial (LA) volume.
Conclusions:
Some conventional and novel echocardiographic parameters are associated with active BP. These alterations could add weight to the staging of disease activity. These echocardiographic findings may also be observed differently according to the clinical form of disease measurement. However, further studies are needed to confirm these differences via echocardiography.
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