Takayasu arteritis (TA) is a chronic inflammatory vasculitis of the aorta and its major branches with a very low incidence in Europe and North America. Our objective was to determine the elastic properties of the affe...Takayasu arteritis (TA) is a chronic inflammatory vasculitis of the aorta and its major branches with a very low incidence in Europe and North America. Our objective was to determine the elastic properties of the affected ascending and descending aortic walls non-invasively in a 14-year-old Iraqi girl with a 3-year history of fever, fatigue, malaise and diffuse pain. Ultrasound and magnetic resonance angiography showed marked thickening of the aorticwall, dilatation of the aortic arch, and decreased luminal diameters of the abdominal aorta and both subclavian arteries, consistent with TA. Ascending and descending aortic elastic properties such as distensibility and stiffness index were markedly reduced compared to a group of healthy controls (n=39): ascending aortic distensibility was 20 kPa-1× 10-3 versus 63± 23 kPa-1× 10-3 in controls, and the ascending aortic stiffness index 9.6 versus 3.5± 1.3 in controls. Although the patient’ s general condition improved rapidly on oral prednisolone and azathioprine and inflammatory parameters normalised within 3 weeks, the aortic elastic parameters did not change during the first 2 weeks of anti-inflammatory treatment. Unfortunately, no further follow-up was possible. Conclusion: In patients with Takayasu arteritis, non-invasive quantification of reduced aortic elastic properties can help to assess aortic involvement, and possibly to follow disease activity and vascular response to therapy.展开更多
Background-Despite successful surgical correction, morbidity of patients with coarctation of the aorta is increased. It is well known that these patients have impaired elastic properties of the prestenotic arteries. T...Background-Despite successful surgical correction, morbidity of patients with coarctation of the aorta is increased. It is well known that these patients have impaired elastic properties of the prestenotic arteries. To find out whether these abnormalities are primarily present or develop later, we studied 17 newborns before and early after surgical repair. Methods and Results-Aortic wall stiffness index and distensibility were calculated using ascending and abdominal aortic diameters determined by M-mode echocardiography and noninvasive estimation of aortic pulse pressure in the right arm and leg. Seventeen patients with aortic coarctation(mean age, 20±26 days) were compared with 17 normal neonates(mean age, 13±7 days) preoperatively and postoperatively(10±6 days after surgery). Ascending aortic distensibility in patients was significantly reduced preoperatively(79±58 versus 105±36; P=0.03) and postoperatively(65±24 versus 105±36; P< 0.005). Preoperative and postoperative ascending aortic stiffness index was higher in patients(preoperative, 5.2±4.4 versus 2.7±0.9; P=0.04; postoperative, 4.0±1.6 versus 2.7±0.9; P< 0.005). Elastic properties of the descending aorta did not differ preoperatively or postoperatively compared with those in normal subjects. Conclusions-Elastic properties of the prestenotic aorta of patients with coarctation seem to be impaired primarily, even in neonates, and remain unchanged early after successful operation. Surgical correction does not resolve inborn pathology of the prestenotic aortic vascular bed.展开更多
文摘Takayasu arteritis (TA) is a chronic inflammatory vasculitis of the aorta and its major branches with a very low incidence in Europe and North America. Our objective was to determine the elastic properties of the affected ascending and descending aortic walls non-invasively in a 14-year-old Iraqi girl with a 3-year history of fever, fatigue, malaise and diffuse pain. Ultrasound and magnetic resonance angiography showed marked thickening of the aorticwall, dilatation of the aortic arch, and decreased luminal diameters of the abdominal aorta and both subclavian arteries, consistent with TA. Ascending and descending aortic elastic properties such as distensibility and stiffness index were markedly reduced compared to a group of healthy controls (n=39): ascending aortic distensibility was 20 kPa-1× 10-3 versus 63± 23 kPa-1× 10-3 in controls, and the ascending aortic stiffness index 9.6 versus 3.5± 1.3 in controls. Although the patient’ s general condition improved rapidly on oral prednisolone and azathioprine and inflammatory parameters normalised within 3 weeks, the aortic elastic parameters did not change during the first 2 weeks of anti-inflammatory treatment. Unfortunately, no further follow-up was possible. Conclusion: In patients with Takayasu arteritis, non-invasive quantification of reduced aortic elastic properties can help to assess aortic involvement, and possibly to follow disease activity and vascular response to therapy.
文摘Background-Despite successful surgical correction, morbidity of patients with coarctation of the aorta is increased. It is well known that these patients have impaired elastic properties of the prestenotic arteries. To find out whether these abnormalities are primarily present or develop later, we studied 17 newborns before and early after surgical repair. Methods and Results-Aortic wall stiffness index and distensibility were calculated using ascending and abdominal aortic diameters determined by M-mode echocardiography and noninvasive estimation of aortic pulse pressure in the right arm and leg. Seventeen patients with aortic coarctation(mean age, 20±26 days) were compared with 17 normal neonates(mean age, 13±7 days) preoperatively and postoperatively(10±6 days after surgery). Ascending aortic distensibility in patients was significantly reduced preoperatively(79±58 versus 105±36; P=0.03) and postoperatively(65±24 versus 105±36; P< 0.005). Preoperative and postoperative ascending aortic stiffness index was higher in patients(preoperative, 5.2±4.4 versus 2.7±0.9; P=0.04; postoperative, 4.0±1.6 versus 2.7±0.9; P< 0.005). Elastic properties of the descending aorta did not differ preoperatively or postoperatively compared with those in normal subjects. Conclusions-Elastic properties of the prestenotic aorta of patients with coarctation seem to be impaired primarily, even in neonates, and remain unchanged early after successful operation. Surgical correction does not resolve inborn pathology of the prestenotic aortic vascular bed.
