Echocardiographic evaluation of Takayasu arteritis including speckled tracking echocardiography and aortic stiffness.

Abstract

Introduction: Despite the burden of Takayasu's arteritis (TA) in India, data on LA, LV and RV strain and aortic stiffness is scanty.

Aims: We assessed these in 100 TA patients (mean age 29.8 years, 70 % females) and correlated with disease activity and duration.

Methods and results: Mean illness duration was 6.34 years, Numano V and III angiographic type was seen in 42 and 20 %. Global LVEF was normal and 6 % had LVEF <50 %. TA patients had significantly lower LVGLS (-16.09 vs -18.9 %), peak atrial longitudinal strain (PALS: 25.03vs 27.1 %), RV-FWS (23.42 vs 25.2 %), and higher mean aortic stiffness (8.39 vs 7.44 m/s) vs controls. The % of patients with LV GLS > -16 %, PALS < -25 %, RV-FWS > -23 % and aortic stiffness (>12 m/s) was 32, 26, 14 and 17 % respectively. Those with LVGLS > -16 % had longer symptom duration (7.02 vs 5.66 years), higher ITAS score (4.96 vs 4.44), higher % prevalence of impaired RV strain (28 % vs 7 %) and impaired PALS (29 % vs 18 %). Those with abnormal aortic stiffness had higher mean ITAS scores (5.58 vs 3.62), higher chance of active disease (ITAS-2010 ≥ 2, 64 % vs 40 %) and longer disease duration.

Conclusion: Despite normal global LVEF, 15-32 % patients with TA had impaired LVGLS, RVFWS, PALS and aortic stiffness. Impaired LVGLS and Aortic stiffness correlated with longer disease duration and higher disease activity. These preliminary findings suggest that strain and aortic stiffness evaluation in TA may help in early identification of subclinical ventricular dysfunction.