Non-invasive assessment of pulmonary artery involvement in Takayasu's arteritis

• Published in: Clinical and experimental rheumatology 1999-03, Vol.17 (2), p.215-218
• Main Authors: VANOLI, M, CASTELLANI, M, BACCHIANI, G, CALI, G, MIETNER, B, ORIGGI, L, SCORZA, R
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Biological and medical sciences; Echocardiography, Doppler, Color; Female; Humans; Investigative techniques of respiratory function; Investigative techniques, diagnostic techniques (general aspects); Lung - blood supply; Male; Medical sciences; Middle Aged; Prospective Studies; Pulmonary Artery - diagnostic imaging; Pulmonary Artery - pathology; Radiography; Radionuclide Imaging; Spirometry; Takayasu Arteritis - diagnosis; Takayasu Arteritis - physiopathology; Technetium Tc 99m Aggregated Albumin; Ventilation-Perfusion Ratio - physiology
• ISSN: 0392-856X; 1593-098X

To evaluate pulmonary involvement in Italian patients with Takayasu's arteritis (TA). A prospective analysis of 15 Italian patients with TA was carried out, including evaluation by perfusion and ventilation lung scintigraphy (planar and tomographic), standard chest X-ray, spirography and color-doppler echocardiography. All the patients were free of respiratory symptoms when examined. In all patients standard chest X-rays and ventilation scintigraphies were normal. 9/15 patients showed unmatched segmental perfusion defects (41 by planar evaluation vs. 48 by SPET). The number of defects was greater in the right lung than in the left (26 vs 18), with a higher frequency of moderate or large defects. Thirteen patients underwent spirography, which proved to be abnormal in 5 cases. Two of these patients were also positive on scintigraphy. No patient showed alterations attributable to TA on color-doppler echocardiography, except for 3 patients with mild to moderate aortic valve regurgitation. Our results show that vascular pulmonary involvement is frequent in TA (60% of cases) even in the absence of clinical signs. The planar image, simpler than the SPET to acquire, was sufficient to make an accurate diagnosis. Italian patients seem to show a pattern of extrapulmonary and pulmonary vascular involvement very similar to that reported in Japanese subjects, and different from that observed in other ethnic groups.