scholarly journals Risk factors for the adverse cardiac outcomes in the patients with Takayasu’s arteritis.

2020 ◽  
Author(s):  
Yu-Jiao Wang ◽  
Li-Li Ma ◽  
Yan Yan ◽  
Ying Sun ◽  
Yong-Shi Wang ◽  
...  

Abstract Background : This study was aimed to investigate the long-term cardiac outcomes and find out risk factors for the deterioration of cardiac structure and function in patients with Takayasu’s arteritis (TAK).Methods : One hundred and ninety-eight TAK patients were recruited in the Department of Rheumatology, Zhongshan Hospital, Fudan University from January 2012 to December 2017. The endpoint of observation was December 31, 2019. Patients were divided into normal, mild-moderate and severe subgroups based on the severity of structural and functional impairment of heart. Comparison of baseline characteristics and treatment among these three subgroups was conducted to identify the risk factors for adverse cardiac outcomes.Results : A total of 60.1% (119/198) of TAK patients exhibited heart involvement on echocardiography at baseline. 70.6% (84/119) and 79.8% (95/119) cases showed pathological valvular and atrioventricular abnormalities, respectively. 68.7% (136/198) of patients were followed up and the median follow-up duration was 28.6 (12.3-43.4) months. 42.7% (58/136) and 22.8% (31/136) of patients had progress in heart’s structure and function. Cox regression showed that serum TNF-α level (HR=1.028, p= 0.021), aortic regurgitation (HR=3.109, p<0.001) and ventricular hypertrophy (HR=2.090, p= 0.006) at baseline were risk factors for the deterioration of cardiac structure. The cases with serum TNF-α levels (≥8.1pg/ml), mild aortic regurgitation and ventricular hypertrophy at baseline had highest risk of structural progression at 83.4%. Using normal subgroup as a control, the deterioration of cardiac structure and function was the most severe in the severe subgroup, with hazard ratios of 16.2 (95% CI, 6.0-44.1, p < 0.001) and 9.0 (95% CI, 3.3-24.5, p<0.001), respectively. The deteriorating events typically occurred within 2 years after diagnosis.Conclusions : To find out if there is heart involvement and progress, it’s indispensable to regularly monitor the serum TNF-α level and cardiac structure in TAK patients during the long-term follow-up.

2007 ◽  
Vol 26 (2) ◽  
pp. S243
Author(s):  
A. Kulikowska ◽  
S.E. Boslaugh ◽  
S. Foerster ◽  
C.H. Gumbiner ◽  
K.E. Ward ◽  
...  

PLoS ONE ◽  
2017 ◽  
Vol 12 (10) ◽  
pp. e0185114 ◽  
Author(s):  
Steffen E. Petersen ◽  
Mihir M. Sanghvi ◽  
Nay Aung ◽  
Jackie A. Cooper ◽  
José Miguel Paiva ◽  
...  

2021 ◽  
Vol 12 ◽  
Author(s):  
Yi-Lin Chen ◽  
Ting-Yan Xu ◽  
Jian-Zhong Xu ◽  
Li-Min Zhu ◽  
Yan Li ◽  
...  

BackgroundCurrent guideline recommends both surgery and drug treatment for primary aldosteronism. Treatment effects on the cardiac structure and function remain under investigation.ObjectiveWe performed a prospective study in patients with primary aldosteronism to compare effects of surgery and drug treatment on the cardiac structure and function as assessed by the left ventricular (LV) pressure-strain loop, a novel echocardiographic technique that incorporates myocardial deformation and LV pressure.MethodsOur study included 39 and 28 patients treated with surgery and a mineralocorticoid antagonist, respectively. We performed conventional and speckle tracking echocardiography at baseline and 3 and 6 months of follow-up.ResultsDuring follow-up, both surgery and drug treatment normalized serum potassium concentration and significantly reduced blood pressure. Both treatments significantly and similarly decreased LV mass index and left atrial volume index. However, only in the surgery group did global wasted work significantly decrease (200.8 ± 86.7 at baseline vs. 142.1 ± 58.1 mmHg% at 6 months) and global work efficiency (91.5 ± 3.1 vs. 93.6 ± 2.3%) and global longitudinal strain (−18.3 ± 2.7 vs. −19.2 ± 1.9%) significantly (p &lt; 0.01) increase at 6 months of follow-up. The corresponding differences from the changes in the drug treatment group were 39.5 mmHg% (95% CI, 17.1, 62.0 mmHg%), −1.64% (95% CI, −2.56, −0.71%), and −0.85% (95% CI, −1.51, −0.20%), respectively. In addition, the changes in global wasted work at 6 months of follow-up was significantly correlated with that in 24-h urinary aldosterone excretion in the drug treatment group (r = 0.54) and two groups combined (r = 0.55), but not the surgery group.ConclusionIn spite of similar serum potassium normalization and blood pressure control, surgical removal of an adrenal gland, but not mineralocorticoid receptor antagonism, showed early improvement in cardiac function.


Hypertension ◽  
2017 ◽  
Vol 70 (suppl_1) ◽  
Author(s):  
Muhammad Oneeb Rehman Mian ◽  
Jean-Luc Bigras ◽  
Rafael Fernandes ◽  
Mariane Bertagnolli ◽  
Li Feng Xie ◽  
...  

Objective: Studies support a causal association between preterm birth and increased risk of cardiovascular diseases. Increased left and right ventricular mass and impaired systolic and diastolic function has been reported in young adults born preterm. However, the impact of extreme preterm birth and prematurity-specific complications on adult cardiac structure and function has not been evaluated. We assessed cardiac structure and function in young adults born extremely preterm (EPT) versus term, and correlated long term cardiac remodeling with neonatal bronchopulmonary dysplasia (BPD). Methods: Eighty five EPT (gest. age = 27.1±1.4 weeks) were recruited along with term-born controls matched for age, sex and socioeconomic status. Birth and neonatal data (gestational age, birth weight, BPD indicated by O 2 requirements at 36 weeks postmenstrual age) was collected. Ambulatory blood pressure (Spacelabs) and echocardiographic measurements (Phillips) were taken. Comparisons were performed using ANOVA or T-test. Results: EPT presented with increased systolic (119±9 vs 116±8 mmHg, P<0.05) and diastolic (68±5 vs 66±6 mmHg, P<0.05) blood pressures. EPT exhibited reduced septal thickness (IVS, 6.8±0.8 vs 7.1±1.1 mm, P<0.05), left ventricular internal dimension (LVID, 46±4 vs 48±5 mm, P<0.05), LV end-diastolic (98±20 vs 106±24 ml, P<0.05) and end-systolic (36±9 vs 40±11 ml, P<0.01) volumes, right ventricular internal dimension (RVID, 22±3 vs 24±4 mm, P<0.05), and LV mass (104±27 vs 115±30 g, P<0.05), but similar LV mass and volume indexes. EPT exhibited increased LV myocardial performance index (0.41±0.04 vs 0.39±0.04, P<0.01), reduced mitral lateral e’ (17.6±2.8 vs 19.1±2.6 cm/s, P<0.01), mitral s’ (10.7±2.3 vs 11.6±2.3 cm/s, P<0.01), tricuspid E’ (15.8±2.7 vs 16.8±2.1 cm/s, P<0.05), and tricuspid S’ (13.1±2.0 vs 14.0±2.0 cm/s, P<0.01) waves, and a trend in reduced mitral E wave (81±14 vs 85±15 cm/s, P=0.09). EPT with neonatal BPD exhibited greater reduction in IVS (6.5±0.8 mm, P<0.05 vs terms), LVID (45±4 mm, P<0.05), LV Mass (98±22 g, P<0.05), and RVID (20±3 mm, P<0.01). Conclusions: EPT exhibit cardiac structural and functional alterations compared to term-born individuals. Neonatal BPD in EPT is a key contributor to long term cardiac remodeling.


2020 ◽  
Vol 9 (12) ◽  
Author(s):  
Sheldon E. Litwin ◽  
Ted D. Adams ◽  
Lance E. Davidson ◽  
Rodrick McKinlay ◽  
Steven C. Simper ◽  
...  

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