Findings of Cardiac Magnetic Resonance Imaging in Asymptomatic Myocardial Ischemic Disease in Takayasu Arteritis

Takayasu arteritis (TA) may affect myocardium and cause coronary stenosis. The aim of this study was to assess the prevalence and pattern of myocardial disease in patients with TA, using late gadolinium enhancement (LGE) of cardiac magnetic resonance imaging (CMRI). Twenty-seven consecutive patients with TA and 80 age- and gender-matched controls without known cardiovascular disease underwent CMRI. The prevalence of myocardial ischemic disease, as revealed by LGE, was compared between patients with TA and controls, and factors associated with myocardial disease were identified in patients with TA. Myocardial ischemic disease, as characterized by LGE on CMRI, was present in 7 (25.9%) of 27 patients with TA, and imaging with LGE showed a typical pattern of myocardial infarction in 6 patients (22.2%). Although both patients with TA and control subjects shared a similar risk of cardiovascular events, the prevalence of myocardial ischemia was >5× greater in patients with TA (p = 0.002 vs controls). No association was found between myocardial disease in patients with TA and cardiovascular atherosclerotic risk factors. The presence of myocardial scarring tended to be more closely associated with specific features of TA such as renovascular hypertension, older age at the onset of TA symptoms, male gender, aneurysmal dilatation, and Numano type V. In conclusion, finding of a significant and unexpectedly high prevalence of occult myocardial scarring in patients with TA indicates the usefulness of CMRI with LGE for the identification of occult myocardial disease in such patients.