Echocardiographic Assessment in Patients with Granulomatosis with Polyangiitis
- 571 Downloads
Granulomatosis with polyangiitis (GPA) is one of the most common forms of systemic vasculitis, which usually involves the upper and lower respiratory tract, but it may affect also multiple organs. The aim of the study was an echocardiographic evaluation of cardiac involvement in GPA patients during remission. Eighty eight patients with GPA were evaluated in the study. The control group consisted of 40 age and sex-matched patients without a previous history of cardiovascular disease. We found that there were no differences between GPA and control groups regarding left atrial enlargement and interventricular septal hypertrophy. In one GPA patient, all heart chambers were enlarged. Left ventricle systolic function was decreased (LVEF ≤ 50%) in eight patients with GPA, and left ventricle wall motion abnormalities were observed in 12 patients. Left ventricle relaxation dysfunction, mitral valve and tricuspid valve regurgitation were observed with the same frequency in both GPA and control groups. Aortic regurgitation was the single abnormality that occurred significantly more often in the GPA group than in controls (28% vs. 7.5%; p = 0.03). Pericardial effusion was observed in three GPA patients and in none from the control group. We conclude that the most common echocardiographic manifestation in GPA patients in remission was aortic valve regurgitation. However, cardiac involvement in such patients is rather rare and in the majority of cases clinically insignificant.
KeywordsAortic valve regurgitation Cardiac involvement Echocardiography Granulomatosis with polyangiitis Remission Vasculitis
The authors thank Jennifer Bigaj for proofreading.
The authors declare no conflict of interest in relation to this article.
- Flossmann O, Berden A, de Groot K, Hagen C, Harper L, Heijl C, Höglund P, Jayne D, Luqmai R, Mahr A, Mukhtyar C, Pusey C, Rasmussen N, Stegeman C, Walsh M, Westman K, for the European Vasculitis Study Group (2011) Long-term patient survival in ANCA-associated vasculitis. Ann Rheum Dis 70:488–494CrossRefPubMedGoogle Scholar
- Hazebroek MR, Kemna MJ, Schalla S, Sanders-van Wijk S, Gerretsen SC, Dennert R, Merken J, Kuznetsova T, Staessen JA (2015) Prevalence and prognostic relevance of cardiac involvement in ANCA-associated vasculitis: eosinophilic granulomatosis with polyangiitis and granulomatosis with polyangiitis. Int J Cardiol 199:170–179CrossRefPubMedGoogle Scholar
- McGeoch L, Carette S, Cuthberston D, Hoffman GS, Khalidi N, Koening CL, Langford CA, CA MA, Moreland L, Monach PA, Seo P, Specks U, Ytterberg SR, Merkel PA, Pagnoux C, Vasculitis Clinical Research Consortium (2015) Cardiac involvement in granulomatosis with polyangiitis. J Rheumatol 42:1209–1212CrossRefPubMedPubMedCentralGoogle Scholar
- Ntatsaki E, Carruthers D, Chakravarty K, D’Cruz D, Harper L, Jayne D, Luqmani R, Mills J, Mooney J, Venning M, Watts RA, BSR and BHPR Standards, Guidelines and Audit Working Group (2014) BSR and BHPR guideline for the management of adults with ANCA-associated vasculitis. Rheumatology (Oxford) 53:2306–2309CrossRefGoogle Scholar
- Ponikowski P, Voors AA, Anker SD, Bueno H, Cleland JG, Coats AJ, Falk V, González-Juanatey JR, Harjola VP, Jankowska EA, Jessup M, Linde C, Nihoyannopoulos P, Parissis JT, Pieske B, Riley JP, Rosano GM, Ruilope LM, Ruschitzka F, Rutten FH, van der Meer P, Authors/Task Force Members (2016) Guidelines for the diagnosis and treatment of acute and chronic heart failure: the task force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC) developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur Heart J 37:2129–2200CrossRefPubMedGoogle Scholar