TY - JOUR T1 - Myocardial Perfusion Imaging in Takayasu Arteritis JF - The Journal of Rheumatology JO - J Rheumatol DO - 10.3899/jrheum.130308 SP - jrheum.130308 AU - CloƩ Comarmond AU - Odile Dessault AU - Jean-Yves Devaux AU - Nathalie Costedoat-Chalumeau AU - Matthieu Resche Rigon AU - Richard Isnard AU - Fabien Koskas AU - Patrice Cacoub AU - David Saadoun Y1 - 2013/10/15 UR - http://www.jrheum.org/content/early/2013/10/09/jrheum.130308.abstract N2 - Objective Myocardial perfusion defects using scintigraphy have been frequently observed in patients with Takayasu arteritis (TA) without coronary stenosis. The aim of our study was to evaluate coronary microcirculation in TA using thallium-201 (201Tl) myocardial scintigraphy and dipyridamole (DPM) as vasodilator agent. Methods Twenty-five consecutive patients with TA were prospectively recruited. They were asymptomatic for cardiac issues and examined using 201Tl myocardial scintigraphy at rest and after coronary artery vasodilation with intravenous DPM. Factors associated with improvement in myocardial perfusion after DPM were identified in patients with TA. Results Among 25 patients with TA, 21 (84%) had 201Tl myocardial perfusion defects and 4 (16%) had normal resting myocardial perfusion. Using a 17-segments model for quantitative image analysis, DPM significantly improved resting 201Tl myocardial perfusion in 14 patients (61%) versus 9 patients without improvement (39%). We were able to examine coronary artery stenoses in 11 patients, including 10 patients with thallium perfusion defects, and significant coronary artery stenoses were present in only 2 patients (18.2%). No significant difference was found in traditional cardiovascular risk factors between TA patients with or without improvement of myocardial perfusion after DPM. The absence of improvement in myocardial perfusion after DPM tended to be closely associated with specific features and prognostic factors of TA, such as aortic regurgitation at diagnosis, renovascular hypertension, longer duration of TA disease, and male sex. Conclusion We found the significantly high prevalence of myocardial perfusion defects mostly improved after vasodilation with DPM, which may indicate the major role of microcirculatory dysfunction in myocardial ischemia in TA. ER -