Key result
Takayasu arteritis with preserved ejection fraction is linked to impaired GLS versus healthy controls.
Why the study?
The alteration of myocardial strain in patients with Takayasu arteritis remains unclear.
Does cardiac magnetic resonance imaging feature tracking detect impaired left ventricular strain in patients with Takayasu arteritis and preserved ejection fraction compared to healthy controls?
Case-Control (n=81)
No
Does cardiac magnetic resonance imaging feature tracking detect impaired left ventricular strain in patients with Takayasu arteritis and preserved ejection fraction compared to healthy controls?
Absolute Event Rate: -13.35% vs -14.77%
p-value: p=0.021
CMR-FT identifies subclinical left ventricular systolic dysfunction via impaired myocardial strain in patients with Takayasu arteritis and preserved ejection fraction.
CMR-FT may detect subclinical LV dysfunction in Takayasu arteritis with preserved EF; leaves open prognostic value and management implications.
Background: The alteration of myocardial strain in patients with Takayasu arteritis (TAK) remains unclear. This study aimed to evaluate left ventricular (LV) stain in patients with TAK and preserved left ventricular ejection fraction (pLVEF) using cardiac magnetic resonance imaging feature tracking (CMR-FT) to analyze risk factors for impaired LV strain and to compare the baseline difference of LV strain between patients with reduced and nonreduced LVEF at 6-month follow-up. Methods: In all, 51 patients with TAK and 30 healthy controls were prospectively enrolled. All participants underwent multiple short- and long-axis cine scans with true fast imaging with steady-state precession sequence. In this observational study, LV global and regional longitudinal, circumferential, and radial strain and their strain rates were analyzed with FT on cine images. The relationship between LV strain and clinical data was explored. The baseline LV strain between patients with TAK and reduced and nonreduced LVEF was compared using transthoracic echocardiography (TTE) at the 6-month follow-up. Results: controls (-22.75%±2.57%), P=0.027] in comparison with normal controls. The longitudinal peak strain (LPS) in the apical (P=0.003) and midventricular regions (P=0.027) and the circumferential peak strain (CPS) in the basal (P=0.021) and midventricular regions (P=0.008) also decreased in patients with TAK. Patients with pulmonary hypertension (PH) or myocardial late gadolinium enhancement (LGE) showed a greater reduction in strain compared with those without PH or LGE. GLS showed a negative association with erythrocyte sedimentation rate (ESR), while GCS showed a positive association with disease duration. In the 30 patients who were followed up, the baseline global and apical circumferential diastolic peak strain rates (DPSR) in patients with reduced LVEF were higher than those in patients without reduced LVEF. Conclusions: In patients with TAK and pLVEF, CMR-FT indicated that both global and segmental myocardial strain decreased. PH, male gender, long disease duration, elevated ESR, and myocardial LGE were associated with declined LV strain. Baseline increased circumferential DPSR may be associated with the decline in LVEF during follow-up.
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Guo et al. (2022) conducted a case-control in Takayasu arteritis with preserved left ventricular ejection fraction (n=81). Takayasu arteritis vs. Healthy controls was evaluated on Global longitudinal peak strain (GLS) (p=0.021). Patients with Takayasu arteritis and preserved ejection fraction exhibited significantly reduced global longitudinal peak strain (-13.35% vs -14.77%) compared to healthy controls.
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