Cardiac involvement in nonspecific (Takayasu’s arteritis)
aortoarteritis
Fifty-four patients (18 males and 36 females, ages 2 to 37 years) with nonspecific aortoarteritis (NSAA) were studied. Evaluation revealed hypertension in 35, congestive heart failure (CHF) in 24, mild to moderate mitral regurgitation in six, and mild aortic regurgitation in two. Erythrocyte sedimentation rate was raised (>35 mm in the first hour) in 38 patients. The arterial lesions included type I in seven, type II in eight, and type Ill in 34. Pulmonary artery involvement was present in 4 (type IV) of the 20 patients in whom it was studied. Selective coronary angiography was done in 11 patients and revealed 90% left main stenosis in one patient. Hemodynamic data revealed raised (>7 mm Hg) mean right atrial pressure in nine, raised mean pulmonary artery pressure (>20 mm Hg) in 29, and raised left ventricular filling pressure (>12 mm Hg) in 27 patients. Radionuclide ventriculography revealed reduced (35 mm) in 38 patients. Arterial lesions. Using the classification of Ueno et a1.8 and of Lupi-Herrera et al.,’ the topography of arterial lesions revealed type I in seven (involvement of arch and or its branches), type II in eight (involvement of thoracoabdominal aorta), and type III (combination of types I and II) in 34 patients. Pulmonary artery involvement was present in 4 (type IV) of the 20 patients in whom it was studied. Among the arterial lesions, the abdominal aorta was involved in 34 patients (Fig. 1, A), subclavian arteries were involved in 32 patients (left subclavian 26, right subclavian ll), and both or a single renal artery was involved in 29 patients. Selective coronary angiography was done
in 11 patients and revealed significant left main stenosis in one patient (Fig. 1, B). The coronary anatomy was normal in the other patients. Hemodynamic study. The hemodynamic parameters were measured at cardiac catheterization in all patients. Mean right atria1 pressure ranged from 2.0 to 17 mm Hg (5.8 f 3.5); pulmonary artery pressure ranged from 12 to 60 (33.9 + 11.70) mm Hg; and left ventricular filling pressure ranged from 10 to 40 (21.77 + 7.90) mm Hg. Increased mean pressure of the right atrium (>7 mm Hg) was present in nine, increased mean pulmonary artery pressure (>20 mm Hg) was found in 29, and increased left ventricular filling pressure (>12 mm Hg) was present in 27 patients. The arteriovenous oxygen difference was available in 24 patients and ranged from 2.5% to 7.45%. It was increased (>4.8 ~01%) in 14 patients. The left ventricular ejection fraction measured on radionuclide ventriculography or left ventricular angiography ranged from 15% to 65% and was decreased (
aortoarteritis
Fifty-four patients (18 males and 36 females, ages 2 to 37 years) with nonspecific aortoarteritis (NSAA) were studied. Evaluation revealed hypertension in 35, congestive heart failure (CHF) in 24, mild to moderate mitral regurgitation in six, and mild aortic regurgitation in two. Erythrocyte sedimentation rate was raised (>35 mm in the first hour) in 38 patients. The arterial lesions included type I in seven, type II in eight, and type Ill in 34. Pulmonary artery involvement was present in 4 (type IV) of the 20 patients in whom it was studied. Selective coronary angiography was done in 11 patients and revealed 90% left main stenosis in one patient. Hemodynamic data revealed raised (>7 mm Hg) mean right atrial pressure in nine, raised mean pulmonary artery pressure (>20 mm Hg) in 29, and raised left ventricular filling pressure (>12 mm Hg) in 27 patients. Radionuclide ventriculography revealed reduced (35 mm) in 38 patients. Arterial lesions. Using the classification of Ueno et a1.8 and of Lupi-Herrera et al.,’ the topography of arterial lesions revealed type I in seven (involvement of arch and or its branches), type II in eight (involvement of thoracoabdominal aorta), and type III (combination of types I and II) in 34 patients. Pulmonary artery involvement was present in 4 (type IV) of the 20 patients in whom it was studied. Among the arterial lesions, the abdominal aorta was involved in 34 patients (Fig. 1, A), subclavian arteries were involved in 32 patients (left subclavian 26, right subclavian ll), and both or a single renal artery was involved in 29 patients. Selective coronary angiography was done
in 11 patients and revealed significant left main stenosis in one patient (Fig. 1, B). The coronary anatomy was normal in the other patients. Hemodynamic study. The hemodynamic parameters were measured at cardiac catheterization in all patients. Mean right atria1 pressure ranged from 2.0 to 17 mm Hg (5.8 f 3.5); pulmonary artery pressure ranged from 12 to 60 (33.9 + 11.70) mm Hg; and left ventricular filling pressure ranged from 10 to 40 (21.77 + 7.90) mm Hg. Increased mean pressure of the right atrium (>7 mm Hg) was present in nine, increased mean pulmonary artery pressure (>20 mm Hg) was found in 29, and increased left ventricular filling pressure (>12 mm Hg) was present in 27 patients. The arteriovenous oxygen difference was available in 24 patients and ranged from 2.5% to 7.45%. It was increased (>4.8 ~01%) in 14 patients. The left ventricular ejection fraction measured on radionuclide ventriculography or left ventricular angiography ranged from 15% to 65% and was decreased (
