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Coronary artery lesions in Takayasu arteritis: Pathological considerations

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Summary

This communication reviews the clinical and pathological features of coronary artery lesions in Takayasu arteritis. The incidence of coronary artery involvement has been reported to be 9% to 10%, and is observed mainly in autopsy cases because coronary artery disease is usually not evident until the occurrence of angina pectoris or myocardial infarction, or after the onset of congestive heart failure. On the basis of pathological features, the following three types of coronary artery lesions can be distinguished: type 1, stenosis or occlusion of the coronary ostia and the proximal segments of the coronary arteries; type 2, diffuse or focal coronary arteritis, which may extend diffusely to all epicardial branches or may involve focal segments, so-called skip lesions; and type 3, coronary aneurysm. Most of the coronary artery lesions in Takayasu arteritis are of type 1. Narrowing of the coronary arteries is mainly due to the extension of the inflammatory processes of proliferation of the intima and contraction of the fibrotic media and adventitia from the ascending aorta. In some cases, coronary stenosis may be caused by coronary arteritis as skip lesions in Takayasu arteritis, but even in these cases the lesions have been reported to affect mainly the proximal segments of the coronary arteries. Diffuse lesions of the coronary artery and coronary artery aneurysm seem to be very rare in Takayasu arteritis. Other causes of coronary ostial stenosis, coronary arteritis and coronary artery aneurysm are also discussed.

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References

  1. Lupi-Herrera E, Sanchez-Torres G, Marcushamer J, Mispireta J, Horwitz S, Vela JE (1977) Takayasu's arteritis. Clinical study of 107 cases. Am Heart J 93:94–103

    PubMed  Google Scholar 

  2. Nasu T (1962) Pathology of pulseless disease: Systemic study and critical review of twenty-one autopsy cases reported in Japan. Angiology 14:225–242

    Google Scholar 

  3. Saito Y, Hirota K, Ito I, Yamaguchi H, Takeda T, Morooka S, Ueda H (1972) Clinical and pathologic studies of five autopsied cases of aortitis syndrome. Jpn Heart J 13:107–117

    PubMed  Google Scholar 

  4. Cipriano PR, Silverman JF, Perlroth MG, Griepp RB, Wexler L (1977) Coronary narrowing in Takayasu's aortitis. Am J Cardiol 39:744–750

    PubMed  Google Scholar 

  5. Rose AG, Sinclair-Smith CC (1980) Takayasu's arteritis: A study of 16 autopsy cases. Arch Pathol Lab Med 104:231–237

    PubMed  Google Scholar 

  6. Isomura T, Hisatomi K, Yanagi I, Shimada S, Uraguchi K, Aoyagi S, Kosuga K, Ohishi K (1988) The surgical treatment of aortic regurgitation secondary to aortitis. Ann Thorac Surg 45:181–185

    PubMed  Google Scholar 

  7. Uehara K, Kitamura N, Ito T, Koyanagi H, Hashimoto A, Konno H (1981) Severe aortic regurgitation in Takayasu's arteritis. J Jpn Assoc Thorac Surg 24:188–197

    Google Scholar 

  8. Juzi U (1967) Arteriitis mit Herzinfarkt. Schweiz Med Wochenschr 13:397–405

    Google Scholar 

  9. Ueda H (1968) Clinical and pathological studies of aortitis syndrome: Committee report. Jpn Heart J 9:76–87

    PubMed  Google Scholar 

  10. Nagata S (1990) Present state of autopsy cases of Takayasu's arteritis (aortitis syndrome) in Japan (in Japanese). Myakkangaku 30:1303–1308

    Google Scholar 

  11. Strachan RW (1964) The natural history of Takayasu's arteriopathy. QJ Med 33:57–69

    Google Scholar 

  12. Nakao K, Ikeda M, Kimata S, Niitani H, Miyahara M, Ishimi Z, Hashiba K, Takeda Y, Ozawa T, Matsushita S, Kuramochi M (1967) Takayasu's arteritis: Clinical report of eighty-four cases and immunological study of seven cases. Circulation 35:1141–1155

    PubMed  Google Scholar 

  13. Lande A, Gross A (1972) Total aortography in the diagnosis of Takayasu's arteritis. Am J Roentgenol Radium Ther Nucl Med 116:165–178

    PubMed  Google Scholar 

  14. Lande A, Rossi P (1975) The value of total aortography in the diagnosis of Takayasu's arteritis. Radiology 114:287–297

    PubMed  Google Scholar 

  15. Frovig AG, Loken AC (1951) Syndrome of obliteration of the arterial branches of the aortic arch due to arteritis. Acta Psychiatr Scand 26:313–337

    Google Scholar 

  16. Ishikawa K (1978) Natural history and classification of occlusive thromboaortopathy (Takayasu's disease). Circulation 57:27–35

    PubMed  Google Scholar 

  17. Ishikawa K (1981) Survival and morbidity after diagnosis of occlusive thromboaortopathy (Takayasu's disease). Am J Cardiol 47:1026–1032

    PubMed  Google Scholar 

  18. Makino N, Orita Y, Takeshita A, Nakamura M, Matsui K, Tokunaga K (1982) Coronary arterial involvement in Takayasu's disease. Jpn Heart J 23:1007–1013

    PubMed  Google Scholar 

  19. Nasu T (1975) Takayasu's truncoarteritis in Japan. A statistical observation of 76 autopsy cases. Pathol Microbiol 43:140–146

    Google Scholar 

  20. Hotchi M, Fujihara M (1982) Aortitis syndrome (in Japanese). Rinsho Meneki 14:350–358

    Google Scholar 

  21. Ueda H, Sugiura M, Ito I, Saito Y, Morooka S (1967) Aortic insufficiency associated with aortitis syndrome. Jpn Heart J 8:107–120

    PubMed  Google Scholar 

  22. Akikusa B, Kondo Y, Muraki M (1981) Aortic insufficiency caused by Takayasu's arteritis without usual clinical features. Arch Pathol Lab Med 105:650–651

    PubMed  Google Scholar 

  23. Amano J, Kameda T, Okamura T, Yakemasa A, Suzuki K, Tanaka J, Suzuki A, Wakiya Y, Abe H, Okada R, Kitamura K, Ban T, Nobuyoshi M (1982) Surgical treatment for coronary arterial lesions associated with aortitis syndrome (in Japanese). Nihon Shinzo Kekkan Geka Gakukai Zasshi 10:94–96

    Google Scholar 

  24. Case Records of the Massachusetts General Hospital 46-1967 (1967) N Engl J Med 277:1025–1033

    Google Scholar 

  25. Rosen N, Gaton E (1972) Takayasu's arteritis of coronary arteries. Arch Pathol 94:225–229

    PubMed  Google Scholar 

  26. Aufderheide AC, Henke BW, Parker EH (1981) Granulomatous coronary arteritis (Takayasu's disease). Arch Pathol Lab Med 105:647–649

    PubMed  Google Scholar 

  27. Payan HM, Gilbert EF (1984) Granulomatous coronary arteritis. Arch Pathol Lab Med 108:136–137

    PubMed  Google Scholar 

  28. Sciagra R, Tebbe U, Rahlf G, Neuhaus KL, Kreuzer H (1986) Fatal outcome of aortocoronary bypass grafting in a 62-year-old man with unsuspected coronary arteritis. Clin Cardiol 9:583–586

    PubMed  Google Scholar 

  29. Wolf RL, Gould NS, Green CA (1987) Unusual arteritis causing myocardial infarction in a child. Arch Pathol Lab Med 111:968–971

    PubMed  Google Scholar 

  30. Tanaka A, Fukayama M, Funata N, Koike M, Saito K (1988) Coronary arteritis and aortoarteritis in the elderly males: A report of two autopsy cases with review of the literature. Virchows Archiv [A] 414:9–14

    Google Scholar 

  31. Falsetti HL, Carroll RJ (1976) Coronary artery aneurysm: A review of literature with a report of eleven new cases. Chest 69:630–636

    PubMed  Google Scholar 

  32. Markis JE, Joff CD, Cohn PF, Feen DJ, Herman MV, Gorlin R (1976) Clinical significance of coronary arterial ectasia. Am J Cardiol 37:217–222

    PubMed  Google Scholar 

  33. Hachiya J (1968) Angiography of pulseless disease. A study of 50 cases (in Japanese). Nippon Acta Radiologica 27:1537–1557

    Google Scholar 

  34. Tamaki M (1968) Coronary arteriography (in Japanese). Nippon Acta Radiologica 28:733–738

    PubMed  Google Scholar 

  35. Ellis R, Kurth RJ (1968) Calcified coronary artery aneurysms. JAMA 203:105–107

    Google Scholar 

  36. Fukuhara M, Koyama O, Onishi K, Adachi K, Tanemoto K, Matsuura S (1979) An autopsy case of aortitis syndrome with aneurysm of bilateral coronary arteries (in Japanese). Shinzo 11:629–634

    Google Scholar 

  37. Fukuda I, Ijima H, Itoh T, Iriyama T, Maeta H, Okamura K, Mitsui T, Hori M (1983) Coronary artery aneurysm associated with aortitis syndrome diagnosed pre- and intraoperatively. Jpn Heart J 24:1007–1015

    PubMed  Google Scholar 

  38. Pritchard CL, Mudd JG, Barner HB (1975) Coronary ostial stenosis. Circulation 52:46–48

    PubMed  Google Scholar 

  39. Hutter JA, Pasaoglu I, Williams BT (1985) The incidence and management of coronary ostial stenosis. J Cardiovasc Surg 26:581–584

    Google Scholar 

  40. Heggtveit HA (1967) The role of coronary ostial stenosis in the etiology of myocardial infarction. Pathol Microbiol 30:716–717

    Google Scholar 

  41. Heggtveit HA (1964) Syphilitic aortitis. A clinicopathologic autopsy study of 100 cases, 1950 to 1960. Circulation 29:346–354

    PubMed  Google Scholar 

  42. Burch GE, Winsor T (1942) Syphilitic coronary stenosis, with myocardial infarction. Am Heart J 24:740–751

    Google Scholar 

  43. Synclair W Jr, Nittsch E (1949) Polyarteritis nodosa of the coronary arteries. Report of a case of an aneurysm and intrapericardial hemorrhage. Am Heart J 38:898–904

    PubMed  Google Scholar 

  44. Harrison CV (1948) Giant-cell or temporal arteritis: Review. J Clin Pathol 1:197–211

    Google Scholar 

  45. Karsner HT, Bayless F (1934) Coronary arteries in rheumatic fever. Am Heart J 9:557–585

    Google Scholar 

  46. Bonfiglio TA, Botti RE, Hagstrom JWC (1972) Coronary arteritis, occlusion and myocardial infarction due to lupus erythematosus. Am Heart J 83:153–158

    PubMed  Google Scholar 

  47. Saphir O (1936) Thromboangiitis obliterans of the coronary arteries and its relation to atherosclerosis. Am Heart J 12:521–535

    Google Scholar 

  48. Suzuki A, Amano J, Tanaka H, Sakamoto T, Sunamori M (1989) Surgical consideration of aortitis involving the aortic root. Circulation 80 (Suppl I):I-222–I-232

    Google Scholar 

  49. Rose AG, Halper J, Factor SM (1984) Primary arteriopathy in Takayasu's disease. Arch Pathol Lab Med 108:644–648

    PubMed  Google Scholar 

  50. Matsubara O, Yoshimura N, Tamura A, Kasuga T, Yamada I, Numano F, Mark EJ (1992) Pathologic features of pulmonary artery in Takayasu's arteritis. Heart Vessels (Supp 7):18–25

    Google Scholar 

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Authors and Affiliations

  1. Department of Pathology, Faculty of Medicine, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, 113, Tokyo, Japan

    Osamu Matsubara, Takeshi Kuwata, Tetsuo Nemoto & Tsutomu Kasuga

  2. Department of Internal Medicine, Faculty of Medicine, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, 113, Tokyo, Japan

    Fujio Numano

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  1. Osamu Matsubara
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  2. Takeshi Kuwata
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  3. Tetsuo Nemoto
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  4. Tsutomu Kasuga
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  5. Fujio Numano
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Matsubara, O., Kuwata, T., Nemoto, T. et al. Coronary artery lesions in Takayasu arteritis: Pathological considerations. Heart Vessels 7 (Suppl 1), 26–31 (1992). https://doi.org/10.1007/BF01744540

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