Prevalence and pattern of myocardial involvement on cardiac magnetic resonance imaging in Takayasu arteritis and its relationship with disease activity.

BACKGROUND: Cardiac involvement in Takayasu arteritis (TA) is the major cause of morbidity and mortality. Cardiovascular magnetic resonance (CMR) is an excellent modality for the assessment of myocardial involvement. Studies have shown myocardial involvement in 25%-27% of patients. OBJECTIVES: To evaluate the prevalence and pattern of myocardial involvement in TA on CMR. We also evaluated any correlation between CMR changes and disease activity score (ITAS 2010 and ITAS-A) assessed at the time of CMR. METHODS: Patients classified as Takayasu arteritis according to Sharma et al. criteria were enrolled in the study. Demographic, clinical, and laboratory data were documented in the predesigned proforma. CMR was performed on a dedicated cardiac 3Tesla MR machine. Disease activity was recorded by ITAS2010 and ITAS-A. RESULTS: A total of 37 TA patients were included. Mean (±SD) age was 29±11 years. Female to male ratio was 3:1. Five patients (14%) had myocardial involvement on CMR. Two (2/5) had myocarditis and three (3/5) patients had features of ischaemic myocardial fibrosis. CONCLUSION: The myocardium is affected in TA, however the prevalence of subclinical myocardial involvement in our study was less (8% vs. 25%-27%) compared to the previous studies. Myocardial involvement trends towards early age of onset, less disease duration, lack of classical risk factors, and more with disease activity.

Prevalence and pattern of myocardial involvement on cardiac magnetic resonance imaging in Takayasu arteritis and its relationship with disease activity / Prevalencia y patrón de afectación miocárdica en la resonancia magnética cardíaca en la arteritis de Takayasu y su relación con la actividad de la enfermedad

Background: Cardiac involvement in Takayasu arteritis (TA) is the major cause of morbidity and mortality. Cardiovascular magnetic resonance (CMR) is an excellent modality for the assessment of myocardial involvement. Studies have shown myocardial involvement in 25%–27% of patients. Objectives: To evaluate the prevalence and pattern of myocardial involvement in TA on CMR. We also evaluated any correlation between CMR changes and disease activity score (ITAS 2010 and ITAS-A) assessed at the time of CMR. Methods: Patients classified as Takayasu arteritis according to Sharma et al. criteria were enrolled in the study. Demographic, clinical, and laboratory data were documented in the predesigned proforma. CMR was performed on a dedicated cardiac 3Tesla MR machine. Disease activity was recorded by ITAS2010 and ITAS-A. Results: A total of 37 TA patients were included. Mean (±SD) age was 29±11 years. Female to male ratio was 3:1. Five patients (14%) had myocardial involvement on CMR. Two (2/5) had myocarditis and three (3/5) patients had features of ischaemic myocardial fibrosis. Conclusion: The myocardium is affected in TA, however the prevalence of subclinical myocardial involvement in our study was less (8% vs. 25%–27%) compared to the previous studies. Myocardial involvement trends towards early age of onset, less disease duration, lack of classical risk factors, and more with disease activity.(AU)

Antecedentes: La afectación cardíaca en la arteritis de Takayasu (AT) es la principal causa de morbmortalidad. La resonancia magnética cardiovascular (RMC) es una modalidad excelente para la evaluación de la afectación miocárdica. Los estudios han demostrado afectación del miocardio en el 25-27% de los pacientes. Objetivos: Evaluar la prevalencia y patrón de afectación miocárdica en AT en RMC. También se evaluó cualquier correlación entre los cambios de RMC y la puntuación de actividad de la enfermedad (ITAS 2010 e ITAS-A) evaluada en el momento de la RMC. Métodos: Pacientes clasificados como arteritis de Takayasu según los criterios de Sharma et al. se inscribieron en el estudio. Los datos demográficos, clínicos y de laboratorio se documentaron en el formulario prediseñado. La RMC se realizó en una máquina de RM cardíaca de 3 Tesla dedicada. La actividad de la enfermedad fue registrada por ITAS 2010 e ITAS-A. Resultados: Se incluyeron un total de 37 pacientes con AT. La edad media (±DE) fue de 29±11 años. La proporción de mujeres a hombres fue de 3:1. Cinco pacientes (14%) tenían afectación miocárdica en la RMC. Dos (2/5) tenían miocarditis y 3 (3/5) pacientes tenían características de fibrosis miocárdica isquémica. Conclusión: El miocardio es afectado en la AT, sin embargo, la prevalencia de afectación miocárdica subclínica en nuestro estudio fue menor (8% vs. 25-27%) en comparación con los estudios previos. La afectación miocárdica tiende hacia una edad de inicio temprana, menor duración de la enfermedad, falta de factores de riesgo clásicos y más con la actividad de la enfermedad.(AU)