Integrated cardiac and vascular assessment in Takayasu arteritis by cardiovascular magnetic resonance.
OBJECTIVE
This study was undertaken to evaluate the value of cardiovascular magnetic resonance (CMR) in the assessment of patients with Takayasu arteritis (TA).


METHODS
Sixteen patients with TA and 2 populations comprising 110 normal volunteers were prospectively recruited. All patients with TA underwent a CMR protocol including measurement of carotid artery wall volume, assessment of left ventricular (LV) volumes and function, and late gadolinium enhancement for the detection of myocardial scarring.


RESULTS
Carotid artery wall volume, total vessel volume, and the wall:outer wall ratio were elevated in TA patients compared with controls (wall volume 1,045 mm(3) in TA patients versus 640 mm(3) in controls, P < 0.001; total vessel volume 2,268 mm(3) in TA patients versus 2,037 mm(3) in controls, P < 0.05; wall:outer wall ratio 48% in TA patients versus 32% in controls, P < 0.001). The lumen volume was reduced in TA (1,224 mm(3) versus 1,398 mm(3) in controls, P < 0.05). In TA, LV function was more dynamic, with reduced end-systolic volume (mean +/- 95% confidence interval ejection fraction 74 +/- 3% versus 67 +/- 1% in controls, P < 0.001; LV end-systolic volume 19 +/- 4 ml/m(2) versus 25 +/- 1 ml/m(2) in controls, P < 0.001). Myocardial late gadolinium enhancement was present in 4 (27%) of 15 patients, indicating previously unrecognized myocardial damage.


CONCLUSIONS
Our findings indicate that an integrated method of cardiovascular assessment by CMR in TA not only provides good delineation of vessel wall thickening, but has also demonstrated dynamic ventricular function, myocardial scarring, and silent myocardial infarction. CMR has benefits compared with other approaches for the assessment and followup of patients with TA, and has potential to identify patients most at risk of complications, allowing early preventative therapy.
Keenan
Niall G
NG
Royal Brompton Hospital, London, UK.
Mason
Justin C
JC
Maceira
Alicia
A
Assomull
Ravi
R
O'Hanlon
Rory
R
Chan
Cheuk
C
Roughton
Michael
M
Andrews
Jacqueline
J
Gatehouse
Peter D
PD
Firmin
David N
DN
Pennell
Dudley J
DJ
D000328:Adult; D000368:Aged; D002339:Carotid Arteries / Q000473:pathology*; D016022:Case-Control Studies; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D006352:Heart Ventricles / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000473:pathology / Q000503:physiopathology; D009206:Myocardium / Q000473:pathology*; D011446:Prospective Studies; D012044:Regression Analysis; D013318:Stroke Volume / Q000502:physiology; D013625:Takayasu Arteritis / Q000473:pathology*; D018487:Ventricular Dysfunction, Left / Q000473:pathology / Q000503:physiopathology