Risk factors and surgical prognosis in patients with aortic valve involvement caused by Takayasu arteritis

• Published in: Arthritis research & therapy 2022-05, Vol.24 (1), p.102-102, Article 102
• Main Authors: Shi, Xuemei, Du, Juan, Li, Taotao, Gao, Na, Fang, Wei, Chen, Suwei, Qiao, Zhiyu, Li, Chengnan, Zhu, Junming, Pan, Lili
• Format: Article
• Language: English
• Subjects: Aneurysms; Anti-inflammatory therapy; Aortic stenosis; Aortic valve; Aortic Valve - diagnostic imaging; Aortic Valve - surgery; Aortic Valve Insufficiency - diagnosis; Aortic Valve Insufficiency - etiology; Aortic Valve Insufficiency - surgery; Arthritis; Calcification; Cardiovascular disease; Complications and side effects; Coronary vessels; Health aspects; Heart; Heart valve diseases; Hospitalization; Hospitals; Humans; Immunoglobulins; Laboratories; Medical prognosis; Prognosis; Pulmonary arteries; Retrospective Studies; Risk Factors; Software; Statistical analysis; Surgical treatment; Takayasu arteritis; Takayasu Arteritis - complications; Takayasu Arteritis - diagnosis; Takayasu Arteritis - surgery; Takayasu's arteritis; Tumor necrosis factor-TNF; Vein & artery diseases; Veins & arteries
• ISSN: 1478-6362; 1478-6354; 1478-6362
• DOI: 10.1186/s13075-022-02788-9

Aortic valve involvement is not uncommon in patients with Takayasu arteritis (TAK) and leading to poor prognosis. The aim of our study was to explore the risk factors of aortic valve involvement and to evaluate the prognosis in TAK patients with aortic valve involvement. In this retrospective study, 172 TAK patients were divided into groups with or without aortic valve involvement to identify the risk factors. Patients who underwent aortic valve surgical treatment were followed up to assess cumulative incidence of postoperative adverse events. A total of 92 TAK patients (53.49%) had aortic valvular lesion. The infiltration of inflammatory cells was found in surgical specimens of aortic valve. Numano type IIb, elevated high-sensitivity C-reactive protein (hs-CRP) level, and dilation of ascending aorta and aortic root were statistically associated with aortic valvular lesion in TAK patients (OR [95%CI] 6.853 [1.685-27.875], p=0.007; 4.896 [1.646-14.561], p=0.004; 4.509 [1.517-13.403], p=0.007; 9.340 [2.188-39.875], p=0.003). The 1-, 5-, and 7-year cumulative incidence of postoperative adverse events were 14.7%, 14.7%, and 31.8%, respectively. Surgical methods (p=0.024, hazard ratio (HR) 0.082) and postoperatively anti-inflammatory therapy (p=0.036, HR 0.144) were identified as potential predictors of postoperative adverse events. Regularly echocardiogram screening is suggested in patients with Numano type IIb and aggressive treatment should be performed early in TAK patients. As for TAK patients with aortic valve surgery, aortic root replacement seems to be the preferred option and regular anti-inflammatory therapy may reduce the occurrence of adverse events of them.