Author + information
- Received January 14, 2011
- Revision received April 21, 2011
- Accepted April 26, 2011
- Published online September 1, 2011.
- María Elena Soto, MsSc⁎,
- Gabriela Meléndez-Ramírez, MsSc†,⁎ (, )
- Eric Kimura-Hayama, MD‡,
- Aloha Meave-Gonzalez, MD†,
- Stephan Achenbach, MD§,
- Mary C. Herrera, MD∥,
- Eid-Lidt Guering, MD¶,
- Erick Alexánderson-Rosas, MD# and
- Pedro A. Reyes, MD⁎
- ↵⁎Reprint requests and correspondence:
Dr. Gabriela Meléndez-Ramírez, Juan Badiano 1, Colonia Sección XVI Del Mexico City, CP 14080, Mexico
Objectives The aim of this study was to use coronary computed tomographic (CT) angiography to characterize coronary artery involvement in patients with known Takayasu arteritis who present with anginal chest pain or shortness of breath.
Background Takayasu arteritis is a primary vasculitis of the large vessels, which mainly affects the aorta and its branches but can also involve the coronary arteries. Coronary CT angiography allows visualization of the coronary vessels and can be used to detect both stenotic and nonstenotic coronary artery lesions.
Methods Eighteen consecutive patients with Takayasu arteritis and angina (typical or atypical) and/or dyspnea underwent contrast-enhanced 64-slice coronary CT angiography. The arterial injury was classified according to the Numano classification. Three patients had prior known coronary artery disease. Coronary arteries were evaluated concerning the presence of obstructive and nonobstructive lesions, and differences between the clinical presentations of patients with and without coronary artery involvement on CT angiography were analyzed.
Results Coronary artery involvement was found in 8 patients (44.4%), 3 of them with clinical activity. A total of 19 coronary lesions were present (13 in ostial locations, 5 in proximal coronary artery segments, and 1 in a mid segment). Eight lesions exceeded 50% diameter reduction (2 in ostial locations and 6 in proximal coronary artery segments). Median disease duration was significantly different between patients with coronary artery involvement (176 months; range 13 to 282 months) compared with those without (21 months; range 1 to 142 months) (p = 0.013).
Conclusions Coronary CT angiography allows the assessment of coronary artery involvement in patients with Takayasu arteritis. These data confirm prior observations that most coronary lesions are in ostial or proximal coronary artery locations. Disease duration in patients with coronary artery involvement is longer than in patients without.
All authors have reported that they have no relationships relevant to the contents of this paper to disclose. Pim J. De Feyter, MD, served as Guest Editor for this paper.
- Received January 14, 2011.
- Revision received April 21, 2011.
- Accepted April 26, 2011.
- American College of Cardiology Foundation