FRI0503 Risk factors of cardiac valvular involvement in patients with takayasu’s arteritis

• Published in: Annals of the rheumatic diseases Vol. 77; no. Suppl 2; p. 779
• Main Author: Pan, L.
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group LTD 01.06.2018
• Subjects: Aortic valve; Arteritis; Heart diseases; Heart failure; Immunoglobulin A; Immunoglobulin G; Morbidity; Regurgitation; Rheumatic heart disease; Risk factors; Takayasu's disease; Vein & artery diseases
• ISSN: 0003-4967; 1468-2060
• DOI: 10.1136/annrheumdis-2018-eular.2226

BackgroundTakayasu’s arteritis (TA) patients with higher disease activity have more cardiovascular morbidity compared to the TA patients with low disease activity, and active group showed a higher incidence of significant aortic valve regurgitation[,1 which may linked heart failure and poor prognosis.2 ObjectivesThe aim of this study is to investigate the imaging and serological features and evaluated disease activity in TA patients with valvular involvement, to find the risk factors of valvular involvement in those patients.Methods103 patients of TA were divided into 2 groups according to with or without valvular involvement. We compared the difference of serological and imaging features in 2 groups. Logistic model was used to determine the risk factors of valvular involvement in TA patients.ResultsAortic insufficiency (62.12%) was most common in valvular involvement group, followed by mitral insufficiency (59.09%), tricuspid involvement (54.55%) and pulmonary involvement (6.06%). In which of them, single valvular involvement was 36.36%, multiple valvular involvement was 63.64%. There were 12 (22.22%) patients developed to heart failure. In valvular involvement patients, most common angiographic type was Numano type V (53.30% vs. 32.43%, p=0.044). The second was Numano type IIb (p=0.034), which were significantly higher than that of non-valvular involvement group. Numano type I was most common type in non-valvular involvement patients, and the proportion was higher than that in the patients with valvular involvement (p=0.034). At the same time, we analysed the involvement of pulmonary and coronary in the 2 groups. TA patients with valvular involvement showed a higher incidence of the coronary lesion than the patients without valvular involvement (p=0.036) (figure 1). Serum level of IgA (p=0.032) and IgG (p=0.015) were significantly higher in the patients with valvular involvement than that the patients without valvular involvement. We also evaluated the parameters of TA disease activity between 2 groups, in patients with valvular involvement, level of CRP was higher than that of non-valvular involvement group (p=0.049). Kerr score (p=0.036) and ITAS (p=0.009) were all higher than those in non-valvular involvement group (figure 2). Logistic regression showed that the risk of valve involvement in TA patients with elevated level of IgG is 23 times higher than the patients with normal level of IgG. (p=0.001, OR=22.068, 95% CI:3.676–132.488), the risk of valvular involvement in TA patients with Numano type IIb (p=0.002, OR=20.352, 95% CI:3.146–131.655) and V (p=0.001, OR=9.437, 95% CI:2.661–33.465) was 20.35 times and 9.44 times higher than other types.Abstract FRI0503 – Figure 1Angiographic type in TA patients with or without valvular involvement. The prevalence of Numano type IIb (21.21% vs. 5.41%, p=0.034) and type V (53.30% vs 32.43%, p=0.044) were higher in TA patients with valvular involvement, TA patients with valvular involvement showed a higher incidence of the coronary lesion than that of non-valvular involvement group (28.79% vs 10.81%, p=0.036).Note P: pulmonary; C: coronaryConclusionsOur study showed that the level of IgA, IgG and CRP were significantly higher in TA patients with valvular involvement and the disease activity was higher in those patients. Elevated IgG, Numano type IIb and type V were the risk factors of valvular involvement in patients with TA.References[1] Lee GY, et al. Cardiovascular manifestations of Takayasu arteritis and their relationship to the disease activity: analysis of 204 Korean patients at a single center2012;159(1):14–20.[2] Yang L, et al: Clinical manifestations and longterm outcome for patients with Takayasu arteritis in China2014;41(12):2439–2446.Disclosure of InterestNone declared