Impact of interventional therapy on top of standard drug therapy on left ventricular structure and function in HFrEF patients complicating with middle aortic syndrome caused by Takayasu arteritis.
10.3760/cma.j.cn112148-20221014-00804
- VernacularTitle:药物联合主动脉介入治疗对TA-MAS合并HFrEF患者左心结构与功能的影响
- Author:
Qian WANG
1
;
Xiong Jing JIANG
1
;
Hui DONG
1
;
Wu Qiang CHE
2
;
Ji Ning HE
1
;
Yang CHEN
1
;
Lei SONG
1
;
Hui Min ZHANG
1
;
Yu Bao ZOU
1
Author Information
1. State Key Laboratory of Cardiovascular Disease, Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.
2. Department of Cardiology, China-Japan Friendship Hospital, Beijing 100029, China.
- Publication Type:Journal Article
- MeSH:
Adolescent;
Child;
Female;
Humans;
Young Adult;
Heart Failure/surgery*;
Longitudinal Studies;
Natriuretic Peptide, Brain;
Peptide Fragments;
Retrospective Studies;
Stroke Volume;
Takayasu Arteritis/surgery*;
Ventricular Function, Left/drug effects*;
Heart Ventricles/drug effects*;
Male;
Cardiovascular Agents/therapeutic use*;
Angioplasty, Balloon;
Stents;
Blood Vessel Prosthesis Implantation
- From:
Chinese Journal of Cardiology
2022;50(12):1207-1213
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To evaluate the impact of interventional therapy on top of drug therapy on cardiac function and structure in heart failure with reduced ejection fraction (HFrEF) patients complicating with middle aortic syndrome caused by Takayasu arteritis (TA-MAS). Methods: It was a retrospective longitudinal study. The data of patients with TA-MAS and HFrEF, who received interventional therapy on top of drug therapy in Fuwai Hospital from January 2010 to September 2020, were collected and analyzed. Baseline clinical data (including demographic data, basic treatment, etc.) were collected through the electronic medical record system. Changes of indexes such as New York Heart Association (NYHA) classification, N-terminal pro-brain natriuretic peptide (NT-proBNP), left ventricular end diastolic diameter (LVEDD), left ventricular ejection fraction (LVEF), left ventricular mass index (LVMI) before and after therapy were analyzed. Results: A total of 10 patients were collected. There were 8 females in this patient cohort, age was (18.4±5.0) years and onset age was (15.3±5.0) years. All 10 patients received standard heart failure medication therapy in addition to hormone and/or immunosuppressive anti-inflammatory therapy, but cardiac function was not improved, so aortic balloon dilatation and/or aortic stenting were performed in these patients. The median follow-up was 3.3(1.3, 5.6) years. On the third day after interventional therapy, the clinical symptoms of the 10 patients were significantly improved, NYHA classfication was restored from preoperative Ⅲ/Ⅳ to Ⅱ at 6 months post intervention(P<0.05). Compared with preoperation, NT-proBNP (P=0.028), LVEDD (P=0.011) and LVMI (P=0.019) were significantly decreased, LVEF was significantly increased (P<0.001) at 6 months after operation. Compared with preoperation, NT-proBNP (P=0.016), LVEDD (P=0.023) and LVMI (P=0.043) remained decreased, LVEF remained increased (P<0.001) at 1 year after operation. Conclusion: Results from short and medium term follow-up show that interventional therapy on top of heart failure drug therpay can effectively improve left cardiac function and attenuate cardiac remodeling in patients with TA-MAS comorbid with HFrEF.
