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Abstract: Takayasu''s arteritis (TA) is primary vasculitis. Cardiac involvements in TA is due to the consequences of the vascular lesions as well as the primary pathology of the heart. The disease activity of TA is known to influence the prognosis of TA. We hypothesized that the cardiovascular involvement of TA is related to the disease activity. We evaluated the cardiovascular manifestations of TA, and we assessed their relation to the disease activity of TA. Two hundred four patients were diagnosed with TA from September, 1994 to March, 2009 according to the diagnostic criteria of the 1990 American College of Rheumatology. Their clinical features and the laboratory, angiographic and echocardiographic findings were retrospectively reviewed. The group with active disease activity was defined as satisfying one of the following criteria: i) an elevated ESR or CRP level, ii) thickened arterial wall with mural enhancement on CT or MR angiography, and iii) carotidynia at the time of the initial diagnosis. One hundred thirty nine patients (69.2%) were classified as the active group. The cardiovascular signs and symptoms were not generally different between the active and inactive groups. The active TA patients had more frequent involvement of the ascending aorta and the aortic arch and its main branches than did the inactive group. The active group showed a higher incidence of significant aortic valve regurgitation and pulmonary hypertension, and a higher level of NT-proBNP. These findings suggest that disease activity plays an important role for the cardiovascular manifestations of TA. The TA patients with higher activity have more cardiovascular morbidity compared to the TA patients with low disease activity. [Copyright &y& Elsevier]

Summary: Aim: The prevalence of myocardial involvement in influenza infection ranges from 0% to 12% depending on the diagnostic criteria used to define myocarditis. Whether such an association holds for the novel influenza A strain, pandemic-2009-H1N1, remains unknown. The aim of this present study is to evaluate the cardiovascular manifestations of pandemic (H1N1) 2009 influenza A (pH1N1) by using standard echocardiography and tissue Doppler imaging (TDI). Methods: Twenty-eight young patients who had been hospitalized for at least 24 h due to an influenza-like illness and tested positive for pH1N1 by real-time polymerase chain reaction were included in the study. All patients underwent echocardiographic studies during the first 72 h of admission. Echocardiographic studies of thirty gender and age matched control subjects were performed and the results were compared. Results: Heart rate was significantly higher in patients infected with pH1N1 virus. Other clinical variables were similar between the two groups (p > 0.05). Echocardiographic variables were also similar except left ventricular end-systolic dimension, which was significantly increased in the patient group (P = 0.042). Left ventricular tissue Doppler assessment at mitral annulus showed that mean systolic velocities of pH1N1 infected patients and control group were statistically similar. However, early diastolic velocity was decreased and late diastolic velocity was increased in the patient group. Therefore early diastolic/late diastolic velocity ratio was significantly decreased in pH1N1 infected patients. Also, isovolumetric contraction time and isovolumetric relaxation time were prolonged and ejection time was significantly shortened in pH1N1 infected patients. As a result, global myocardial performance index was significantly higher in pH1N1 infected patients (p < 0.001). Right ventricular tissue Doppler assessment at tricuspid annulus showed similar results with the left ventricular measurements. Conclusion: The results of the study suggest an association between hospitalized pH1N1 and subclinical cardiac dysfunction as measured by tissue Doppler echocardiography. [Copyright &y& Elsevier]