Pulmonary hypertension in Takayasu arteritis

Sari, Alper; Şener, Yusuf Ziya; Fırat, Esra; Armağan, Berkan; Erden, Abdülsamet; Okşul, Metin; Hekimsoy, Vedat; Asil, Serkan; Kılıç, Levent; Kiraz, Sedat; Kaya, Ergün Barış; Tokgözoğlu, Lâle; Akdoğan, Ali

doi:10.1111/1756-185x.13354

Cited by 27 publications

(25 citation statements)

References 25 publications

(32 reference statements)

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“…Additionally, in contrast to the results of Lee et al [23], we did not nd a relationship between PAI and disease activity. This is in accordance with a report from China [24]. The discrepancy between these results could be due to differences in the disease stage of TA because of its gradual onset.…”

Section: Discussionsupporting

confidence: 91%

Long-Term Outcomes and Prognostic Predictors of Takayasu Arteritis Patients With Pulmonary Artery Involvement

Huang

Gao

Liu

et al. 2021

Preprint

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Objective: This study aimed to investigate the clinical characteristics, long-term results, and prognostic predictors of Takayasu arteritis (TA) patients with pulmonary artery involvement (PAI).Methods: A total of 806 TA patients admitted to Fuwai Hospital were screened for inclusion in this study. Clinical symptoms, imaging features, and prognosis were analyzed, and patients were categorized into those with and those without pulmonary hypertension (PH). Additionally, risk factors associated with cardiac death and repeated hospitalization were explored. Results: Among 806 TA patients, a total of 142 patients with PAI were included, 90.8% (n = 129) of whom had PH (diagnosed by right heart catheterization) and 9.2% (n = 13) of whom did not have PH. The median follow-up time was 54 months (range, 29–83 months). Sixteen patients died from right heart failure caused by PH. Patients with PH were significantly more likely to have worse outcomes than patients without PH (P = 0.027). The multivariate Cox proportional regression hazard model showed that 6-min walk distance (6MWD) and PH-targeted therapy were independent prognostic predictors of cardiac death and hospital readmissions.Conclusion: This study found that that a significant proportion of TA patients with PAI had PH. Patients with PH had a worse prognosis than patients without PH. Further 6MWD and PH-targeted therapy were independent prognostic predictors. In future, a multi-center clinical studies are needed to further clarify this issue prospectively.

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Section: Discussionsupporting

confidence: 91%

Long-Term Outcomes and Prognostic Predictors of Takayasu Arteritis Patients With Pulmonary Artery Involvement

Huang

Gao

Liu

et al. 2021

Preprint

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“…The effect of PAI has not been fully elucidated. PAI is reported with TAK in 5.7 to 25.93 % (1)(2)(3)(4)(5)(6)(7)(8)(9)(10). In this study, the presence of PAI was 14.6 %, consistent with previous studies.…”

Section: Discussionsupporting

confidence: 91%

“…Vessel wall in ammation leads to arterial wall thickening, dilation, stenosis and occlusion. PA involvement (PAI) occurs in 5.7-25.93 % of all cases (1)(2)(3)(4)(5)(6)(7)(8)(9)(10). TAK with PAI is occasionally complicated with pulmonary hypertension (PH), resulting in the risk of early mortality (8, 11).…”

Section: Introductionmentioning

confidence: 99%

The clinical features of pulmonary artery involvement in Takayasu arteritis and its relationship with ischemic heart diseases and infection

Mukoyama

Shirakashi

Tanaka

et al. 2021

Preprint

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BackgroundPulmonary artery involvement (PAI) in Takayasu arteritis (TAK) can lead to severe complications, but the relationship between the two has not been fully clarified.MethodsWe retrospectively investigated 166 consecutive patients with TAK who attended Kyoto University Hospital from 1997 to 2018. The demographic data, clinical symptoms and signs, comorbidities, treatments, and imaging findings were compared between patients with and without PAI. TAK was diagnosed based on the American College of Rheumatology Classification Criteria (1990) or the Japanese Clinical Diagnostic Criteria (2008). PAI was identified using enhanced computed tomography, magnetic resonance imaging, or lung scintigraphy.ResultsPAI was detected in 14.6 % (n = 24) of total TAK patients. Dyspnea (25.0 % vs. 8.6 %; p = 0.043), pulmonary hypertension (PH) (29.2 % vs. 0.7 %; p < 0.001), ischemic heart disease (IHD) (29 % vs. 9.3 %; p = 0.018), respiratory infection (25.0 % vs. 6.0 %; p = 0.009) and nontuberculous mycobacteria (NTM) infection (20.8 % vs. 0.8 %; p < 0.001) were significantly more frequent, and renal artery stenosis (0 % vs. 17 %; p = 0.007) was significantly less frequent in TAK patients with PAI than in those without PAI. PAI was an independent risk factor for NTM in multivariate analysis (odds ratio, 36.16; confidence interval: 3.61-361.82; p = 0.002).ConclusionsTAK patients with PAI more frequently have dyspnea, PH, IHD, and respiratory infection, including NTM, than TAK patients without PAI.

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“…Patients with PAI are more prone to develop PH than those without PAI. Sari, et al 12 reported that PH was present in 25.0% of patients with PAI and 7.7% without PAI. In a case review conducted by Toledano, et al 7 , 42.2% of patients with PAI also had PH.…”

Section: Discussionmentioning

confidence: 98%

“…However, the pulmonary circulation is often overlooked in the initial assessment of patients with TA. Pulmonary hypertension (PH) is a major complication in the course of TA-associated PAI [6][7][8][9][10][11][12] . The diagnosis of PH carries a 7-fold higher risk of early mortality in many different clinical conditions 13 .…”

mentioning

confidence: 99%

Pulmonary Artery Involvement in Patients with Takayasu Arteritis

Lv²,

Dang³

et al. 2019

J Rheumatol

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Objective.This study was performed to explore the clinical manifestations and longterm prognosis in patients with Takayasu arteritis (TA) with pulmonary artery involvement (PAI).Methods.The medical records of 194 patients with TA who underwent traditional catheter angiography or computed tomography of pulmonary artery from 2009 to 2016 were retrospectively reviewed. The clinical manifestations, angiographic features, and mortality of 128 patients with TA with PAI were further analyzed.Results.Patients with TA with PAI had a higher risk of pulmonary hypertension (PH) than patients with TA alone (61.7% vs 7.6%, p < 0.001). Patients with PAI and PH more frequently developed dyspnea, hemoptysis, and lower limbs edema (all p < 0.05) than those without PH. Patients with PH also had a higher incidence of bilateral PAI (84.8% vs 34.7%, p < 0.001) and a higher pulmonary artery obstruction index [23 (interquartile range 20–27) vs 10 (6–15), p < 0.001]. Left heart disease was presented in 39 (30.5%) patients with TA with PAI. During the median followup of 38 (21–58) months, 19 and 2 deaths occurred among patients with and without PH, respectively. Among patients with PAI, the mortality rate was 7 times higher in patients with than without PH (p = 0.009). Independent predictors of mortality were the disease duration (p = 0.047), New York Heart Association class III/IV (p = 0.019), right ventricular systolic dysfunction (p = 0.019), and respiratory failure (p = 0.007).Conclusion.Patients with TA with PAI have a higher risk of developing PH than patients with TA alone. The presence of PH in patients with PAI increases the risk of early mortality.

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Pulmonary hypertension in Takayasu arteritis

Abstract: Pulmonary hypertension is not infrequent in TA patients and all the potential causes of PH should be carefully evaluated. Patients with severe or treatment-resistant disease are prone to have PH. PAH-specific agents may be effective in patients with group 4 PH.

Cited by 27 publications

References 25 publications

Long-Term Outcomes and Prognostic Predictors of Takayasu Arteritis Patients With Pulmonary Artery Involvement

Long-Term Outcomes and Prognostic Predictors of Takayasu Arteritis Patients With Pulmonary Artery Involvement

The clinical features of pulmonary artery involvement in Takayasu arteritis and its relationship with ischemic heart diseases and infection

Pulmonary Artery Involvement in Patients with Takayasu Arteritis

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