Takayasu arteritis (TA) is defined by widespread aortic, big, and midrange artery wall inflammation. For this study, researchers wanted to look at the morphological and elastic features of the aorta and major arteries, as well as how they affected left ventricular (LV) mechanics in children with TA. From February 2015 to July 2017, seven pediatric TA patients (6 female patients, 13.8 + 3.2 years) were evaluated using magnetic resonance imaging, vascular ultrasonography, applanation tonometry, and echocardiography and compared with 7 age- and sex-matched controls. The Pediatric Vasculitis Activity Score was used to evaluate the clinical activity of Takayasu arteritis (PVAS).
When compared to controls, pediatric TA patients had higher carotid-to-radial artery pulse wave velocity (8.1 ± 1.8 vs. 6.4 ± 0.6 m/s, p = 0.03) and higher carotid-to-femoral artery pulse wave velocity (8.3 ± 1.9 vs. 5.1 ± 0.8 m/s, p < 0.01). Patients had a higher LV mass index (74.3 ± 18.8 vs. 56.3 ± 10.9 g/m2, p = 0.04), altered myocardial deformation with increased basal rotation (−9.8 ± 4.5 vs. −4.0 ± 2.0 degrees, p = 0.01) and torsion (19.9 ± 8.1 vs. 9.1 ± 3.1 degrees, p = 0.01), and impaired LV diastolic function with a lower mitral valve E/A ratio (1.45 ± 0.17 vs. 2.40 ± 0.84, p = 0.01), increased mitral valve E/E′ ratio (6.8 ± 1.4 vs. 4.9 ± 0.7, p < 0.01), and increased pulmonary vein A-wave velocity (26.7 ± 5.7 vs. 16.8 ± 3.3 cm/s, p = 0.03). Carotid-to-radial artery pulse wave velocity was shown to be related to systolic (R = 0.94, p < 0.01), diastolic (R = 0.85, p = 0.02), and mean blood pressure (R = 0.91, p < 0.01) blood pressure, as well as disease activity by PVAS (R = 0.75, p = 0.05). The PVAS was related to carotid-to-radial artery pulse wave velocity (R = 0.75, p = 0.05), systolic (R = 0.84, p = 0.02), diastolic (R = 0.82, p = 0.03), and mean blood pressure (R = 0.84, p = 0.02).
Pediatric TA patients have increased arterial stiffness, which is linked to higher blood pressure and TA disease activity. Patients with pediatric TA have abnormal LV mechanics, LV hypertrophy, and poor diastolic function.
