Clinical characteristics of pulmonary artery involvement in patients with Takayasu arteritis between pulmonary hypertension and non-pulmonary hypertension

Abstract

Background: Multiple Takayasu arteritis (TA) is a chronic non-specific large to medium vasculitis disease that mainly accumulates the aorta and its branches. Pulmonary vascular disease is often seen as stenosis and occlusion, and patients may show no moderate to severe pulmonary hypertension. The study sought to summarize the clinical characteristics of patients with pulmonary hypertension (PH) involving the pulmonary artery caused by TA.Methods: Twenty-nine patients with TA treated at the General Hospital of Ningxia Medical University from September 2009 to December 2021 were collected. All the patients had TA involving the pulmonary artery, and were divided into the PH group (n=17 patients) and the non-PH group (n=12). The diagnoses of pulmonary Takayasu arteritis (PTA) were used the 1990 diagnostic criteria of the American Rheumatic Association and the 1996 improved Ishikawa diagnostic criteria. Computed tomography angiography (CTA) of the patients after treatment was determined, and the laboratory tests, echocardiography, pulmonary and systemic artery angiography were assessed. Results:The patients had an average age of onset of 33.5 [19-60] years. All the cases of PH were confirmed by echocardiography and it was suggested that the bilateral side easier to involve pulmonary arteries than the unilateral side, and the right side than the left side. At admission, the ESR and N pro-BNP level of the PH group did not differ significantly to those of the non-PH Group. There were significant differences between the two groups in patients in terms of the type II of TA imaging diagnosis (P=0.030). The accuracy of diagnosing PH with bilateral pulmonary vascular involvement was significantly higher in the PH group than the non-PH group (P=0.003). The diagnostic accuracy of pulmonary vascular lumen obstruction in the PH group was significant difference (P<0.05). The diagnostic accuracy of pleural effusion in the PH group was significantly higher than that of the non-PH group (P=0.001) for lung field signs. The diameters of the right atrium and pulmonary artery differed significantly between the two groups (P=0.013).Conclusions: Patients with TA involving the pulmonary artery mainly complained of shortness of breath.Most of these patients had PH.