The application value of echocardiography in the evaluation of cardiac involvement and its degree in patients with Takayasu arteritis

Tang Tieqi; Fu Jiarong; Liu Jinfeng; Zhang Chun

doi:10.3760/j.issn.1673-4777.2023.12.007

Abstract：Objective To investigate the application value of echocardiography in the evaluation of cardiac involvement and its degree in patients with Takayasu arteritis(TA).Methods The medical records of 127 patients diagnosed with TA who were treated in Beijing Anzhen Hospital,Capital Medical University from January 2015 to December 2021 were collected and retrospectively analyzed.According to the presence or absence of cardiac involvement,patients were divided into cardiac involvement group(68 cases)and non-cardiac involvement group(59 cases).The patients of cardiac involvement group was further divided into pulmonary hypertension group(11 cases)and non-pulmonary hypertension group(57 cases)according to the presence or absence of pulmonary hypertension.The differences in general data between the cardiac involvement group and the non-cardiac involvement group were compared,and the similarities and differences in echocardiographic indicators between the groups were explored.Results The erythrocyte sedimentation rate in the cardiac involvement group was significantly higher than that in the non-cardiac involvement group[16.00(7.00,39.00)mm/1 h vs 14.50(7.50,16.00)mm/1 h](Z=-2.238,P=0.025).The left atrial diameter,interventricular septal thickness,left ventricular posterior wall thickness,left ventricular end-diastolic diameter,left ventricular end-systolic diameter,left ventricular myocardial mass,left ventricular myocardial mass index,maximum diameter of aortic sinus,maximum diameter of proximal ascending aorta,main pulmonary artery diameter,and peak velocity of early mitral valve diastolic blood flow in the cardiac involvement group were all higher than those in the non cardiac involvement group,and the left ventricular ejection fraction was lower than that in the non-cardiac involvement group(all P＜0.05);the subgroup analysis showed that,the pulmonary hypertension group and the non-pulmonary hypertension group had statistically significant differences in the above indicators,except for the maximum diameter of aortic sinus in pulmonary hypertension group and the peak velocity of early mitral valve diastolic blood flow in non-pulmonary hypertension group,compared with the non-cardiac involvement group(all P＜0.05),and the trend was consistent with that of the cardiac involvement group.The main classification manifestations of patients with cardiac involvement in TA were hypertensive heart disease,coronary atherosclerotic heart disease,myocardial abnormalities,valve dysfunction,and pulmonary hypertension.Among the 68 patients in the cardiac involvement group,18 patients(26.5％)showed myocardial abnormalities,and 55 patients(80.9％)showed valve dysfunction.Conclusion TA combined with cardiac involvement is common.Echocardiography can detect and comprehensively evaluate cardiac involvement and its degree as soon as possible.It has great clinical application value in the diagnosis,treatment,and follow-up of patients with TA complicated with cardiac involvement.