title: Coronary CT angiography in Takayasu arteritis.
abstract: OBJECTIVE
  The aim of this study was to use coronary computed tomographic (CT) angiography to characterize coronary artery involvement in patients with known Takayasu arteritis who present with anginal chest pain or shortness of breath.
  
  
  BACKGROUND
  Takayasu arteritis is a primary vasculitis of the large vessels, which mainly affects the aorta and its branches but can also involve the coronary arteries. Coronary CT angiography allows visualization of the coronary vessels and can be used to detect both stenotic and nonstenotic coronary artery lesions.
  
  
  METHODS
  Eighteen consecutive patients with Takayasu arteritis and angina (typical or atypical) and/or dyspnea underwent contrast-enhanced 64-slice coronary CT angiography. The arterial injury was classified according to the Numano classification. Three patients had prior known coronary artery disease. Coronary arteries were evaluated concerning the presence of obstructive and nonobstructive lesions, and differences between the clinical presentations of patients with and without coronary artery involvement on CT angiography were analyzed.
  
  
  RESULTS
  Coronary artery involvement was found in 8 patients (44.4%), 3 of them with clinical activity. A total of 19 coronary lesions were present (13 in ostial locations, 5 in proximal coronary artery segments, and 1 in a mid segment). Eight lesions exceeded 50% diameter reduction (2 in ostial locations and 6 in proximal coronary artery segments). Median disease duration was significantly different between patients with coronary artery involvement (176 months; range 13 to 282 months) compared with those without (21 months; range 1 to 142 months) (p = 0.013).
  
  
  CONCLUSIONS
  Coronary CT angiography allows the assessment of coronary artery involvement in patients with Takayasu arteritis. These data confirm prior observations that most coronary lesions are in ostial or proximal coronary artery locations. Disease duration in patients with coronary artery involvement is longer than in patients without.
authors.affiliation: Immunology Department, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico.
authors.forename: María Elena
authors.initials: ME
authors.lastname: Soto
authors.forename: Gabriela
authors.initials: G
authors.lastname: Meléndez-Ramírez
authors.forename: Eric
authors.initials: E
authors.lastname: Kimura-Hayama
authors.forename: Aloha
authors.initials: A
authors.lastname: Meave-Gonzalez
authors.forename: Stephan
authors.initials: S
authors.lastname: Achenbach
authors.forename: Mary C
authors.initials: MC
authors.lastname: Herrera
authors.forename: Eid-Lidt
authors.initials: EL
authors.lastname: Guering
authors.forename: Erick
authors.initials: E
authors.lastname: Alexánderson-Rosas
authors.forename: Pedro A
authors.initials: PA
authors.lastname: Reyes
mesh_terms: D000328:Adult; D000787:Angina Pectoris / Q000209:etiology; D016009:Chi-Square Distribution; D017023:Coronary Angiography / Q000379:methods*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000209:etiology; D018450:Disease Progression; D004417:Dyspnea / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008800:Mexico; D008875:Middle Aged; D011237:Predictive Value of Tests; D012720:Severity of Illness Index; D013625:Takayasu Arteritis / Q000150:complications / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed; D055815:Young Adult