Современная ревматология (Oct 2022)
Clinical course, laboratory and instrumental markers of vascular inflammation in the Kyrgyz cohort of patients with Takayasu's arteritis
Abstract
Lack of highly sensitive and specific methods of laboratory and instrumental diagnostics leads to difficulties in timely verification of Takayasu's arteritis (AT).Objective: to analyze the clinical course, laboratory and instrumental markers of vascular inflammation in the Kyrgyz cohort of patients with AT.Patients and methods. The study included 75 patients with a reliable diagnosis of AT, who were hospitalized and observed on an outpatient basis at the clinic of the National Center for Cardiology and Therapy named after acad. Mirsaida Mirrakhimova from January 2011 to April 2022. Patients were examined using clinical, laboratory and instrumental methods once every 2 years. The follow-up period was 1–5 years in 45 (60%) patients and 6–15 years in the remaining 30 (40%) patients. All patients underwent a clinical and standard laboratory work-up with CRP and interleukin 6 levels assessment, as well as ultrasound Dopplerography of peripheral arteries in the color Doppler mapping mode and multislice computed tomography-panaortography.Results and discussion. Lesions of the common carotid (85.33%) and subclavian (84%) arteries were detected more often. Involvement of the abdominal aorta was noted in 60% of patients and was accompanied by stenosis of the renal arteries in 100% of cases. The clinical picture of the disease was mainly represented by cardiac pathology in the form of arterial hypertension (84%) and aortic regurgitation (68%) with the development of decompensated chronic heart failure in 15% of patients. During the dynamic observation, significant improvement in the course of the disease, clinical symptoms, decrease in the severity of vascular changes were not revealed, with the exception of a decrease in the clinical activity of AT (p<0.05) in one third of patients (37.4%). Conclusion. The severity of clinical manifestations and the course of AT in the Kyrgyz cohort was due to cardiovascular pathology. As dynamic observation showed, the lack of significant improvement in the course of the disease was largely due to the long duration of chronic inflammation, late diagnosis, development of irreversible stenotic, occlusive and aneurysmal changes, as well as the fact that patients did not receive adequate pathogenetic therapy at the onset of the disease. Keywords: <0.05) in one third of patients (37.4%).Conclusion. The severity of clinical manifestations and the course of AT in the Kyrgyz cohort was due to cardiovascular pathology. As dynamic observation showed, the lack of significant improvement in the course of the disease was largely due to the long duration of chronic inflammation, late diagnosis, development of irreversible stenotic, occlusive and aneurysmal changes, as well as the fact that patients did not receive adequate pathogenetic therapy at the onset of the disease.
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