Background Takayasu's arteritis (TKA) is a chronic large-vessel vasculitis that predominantly affects aorta and its major branches. Cardiac lesion in TKA could reach up to 8.6%, involving valve, myocardium and coronary artery or secondary to hypertension or pulmonary hypertension due to TKA . The valvular involvement is one of the causes for the unfavorable prognosis of TKA . Limited data about TKA with valvular involvement in Chinese patients have been reported yet.
Objectives To investigate the clinical features of valvular lesions in TKA.
Methods We retrospectively analyzed 22 medical records of TKA with valvular lesions from a total of 116 TKA admitted patients in Anzhen Hospital, Capital Medical University from January 2012 to January 2015.
Results The spectrum of valvular involvements were aortic regurgitation (11,50%,), mitral regurgitation (1,4.5%), aortic stenosis (1,4.5%), mitral stenosis (1,4.5%) and multiple valvular disease (7,36.5%). 64.7% of the aortic regurgitation patients had aortic root dilation. Heart failure was the commonest manifestation (63.6%). Patients with aortic regurgitation were more likely to be positive for elevated erythrocyte sedimentation rate than those without aortic regurgitation (i58.8% vs. 0, P=0.04). Glucocorticoid and/or immunosuppression were administered on 11 (50%) patients. One (4.5%) patient received Tocilizumab injection. Surgeries were performed on 12 (54.5%) patients with cardiac architecture changing reversibly within one week after operation (P<0.05, Table 1). Three patients had aortic valve detachment or perivalvular leakage 6–36 months after primary valvular surgery. Three patients died during 10–46 month follow-up, with none of whom taking any anti-inflammatory treatments.
Conclusions Aortic regurgitation is the prominent valvular lesion in TKA, mainly secondary to aortic root dilation. Operation could cut off the myocardium reconstruction promptly. The early surgical complication is rare, while perivalvular leakage may occur during longstanding follow-up. Poor inflammatory control might lead to adverse prognosis.
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Soto ME, Espinola N, Flores-Suarez LF, et al. Takayasu arteritis: clinical features in 110 Mexican Mestizo patients and cardiovascular impact on survival and prognosis. Clin Exp Rheumatol. 2008, 26(3 Suppl 49):S9–15.
Disclosure of Interest None declared
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