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Research article
Lindi Jiang
Zhongshan Hospital Fudan University
Corresponding Author
ORCiD: https://orcid.org/0000-0001-7747-7788
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background
Hypertension occurred in 30–80% of Takayasu arteritis (TAK) patients around the world and the occurrence of hypertension might worsen the disease prognosis. This study aimed to investigate the clinical characteristics and imaging phenotypes, as well as their associations with events free survival (EFS) in hypertensive TAK population.
Methods
This current research was based on a prospectively on-going observational cohort-the East China Takayasu Arteritis (ECTA) cohort, centered in Zhongshan Hospital, Fudan University. Totally, 204 hypertensive TAK patients were enrolled between January 2013 and December 2019. Clinical characteristics and imaging phenotypes of each case were evaluated and their associations with the EFS by the end of August 30, 2020 were analyzed.
Results
Severe hypertension accounted for 46.1% of the entire population. Three specific imaging phenotypes were identified: Cluster 1: involvement of the abdominal aorta and/or renal artery (27.5%); Cluster 2: involvement of the ascending aorta, thoracic aorta, and the aortic arch and/or its branches (18.6%); and Cluster 3: combined involvement of Cluster 1 and 2 (53.9%). Clinical characteristics, especially hypertensive severity, differed greatly among three imaging clusters. In all, 187 patients were followed-up for a median of 46 (9-102) months; 127 (67.9%) cases did not experience any events, while 72 events were observed in 60 patients. The overall blood pressure control rate was 50.8%, and the EFS was 67.9% by the end of the follow-up. Multivariate Cox regression indicated that controlled blood pressure (HR = 2.13, 95% CI 1.32–3.74), Cluster 1 (HR = 0.69, 95% CI 0.48–0.92) and Cluster 3 (HR = 0.72, 95% CI 0.43–0.94) imaging phenotype was associated with the EFS. Kaplan–Meier curves showed that patients with controlled blood pressure showed better EFS (p = 0.043). Furthermore, patients had controlled blood pressure and Cluster 1 phenotype was set as reference, better EFS was observed in patients with controlled blood pressure and Cluster 2 phenotype (HR = 2.21, 95%CI 1.47–4.32), while those had uncontrolled blood pressure and Cluster 1 phenotype (HR = 0.64, 95%CI: 0.52–0.89) and those had uncontrolled blood pressure and Cluster 3 phenotype (HR = 0.83, 95%CI: 0.76–0.92) suffered worse EFS.
Conclusion
Blood pressure control status and imaging phenotypes showed significant effects on the EFS for hypertensive TAK.
Keywords
Takayasu arteritis, hypertension, hypertensive severity, imaging phenotype, blood pressure control status, events free survival
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CURRENT STATUS: Published
View the published article at Arthritis Research & Therapy.
Version 1
Posted 17 May, 2021
No community comments so far
Editorial decision: Major revision
On 13 Jun, 2021
Review #2 received
Received 11 Jun, 2021
Review #1 received
Received 04 Jun, 2021
Reviewer #2 agreed
On 31 May, 2021
Reviews received
Received 21 May, 2021
Reviewer #1 agreed
On 20 May, 2021
Reviewers invited
Invitations sent on 16 May, 2021
Editor assigned
On 13 May, 2021
Submission checks complete
On 13 May, 2021
Editor invited
On 13 May, 2021
First submitted
On 12 May, 2021
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Rheumatology
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A new preprint design is coming!
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See the published version of this preprint at Arthritis Research & Therapy.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Lindi Jiang
Zhongshan Hospital Fudan University
Corresponding Author
ORCiD: https://orcid.org/0000-0001-7747-7788
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at Arthritis Research & Therapy.
Version 1
Posted 17 May, 2021
No community comments so far
Editorial decision: Major revision
On 13 Jun, 2021
Review #2 received
Received 11 Jun, 2021
Review #1 received
Received 04 Jun, 2021
Reviewer #2 agreed
On 31 May, 2021
Reviews received
Received 21 May, 2021
Reviewer #1 agreed
On 20 May, 2021
Reviewers invited
Invitations sent on 16 May, 2021
Editor assigned
On 13 May, 2021
Submission checks complete
On 13 May, 2021
Editor invited
On 13 May, 2021
First submitted
On 12 May, 2021
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Rheumatology
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at Arthritis Research & Therapy.
Background
Hypertension occurred in 30–80% of Takayasu arteritis (TAK) patients around the world and the occurrence of hypertension might worsen the disease prognosis. This study aimed to investigate the clinical characteristics and imaging phenotypes, as well as their associations with events free survival (EFS) in hypertensive TAK population.
Methods
This current research was based on a prospectively on-going observational cohort-the East China Takayasu Arteritis (ECTA) cohort, centered in Zhongshan Hospital, Fudan University. Totally, 204 hypertensive TAK patients were enrolled between January 2013 and December 2019. Clinical characteristics and imaging phenotypes of each case were evaluated and their associations with the EFS by the end of August 30, 2020 were analyzed.
Results
Severe hypertension accounted for 46.1% of the entire population. Three specific imaging phenotypes were identified: Cluster 1: involvement of the abdominal aorta and/or renal artery (27.5%); Cluster 2: involvement of the ascending aorta, thoracic aorta, and the aortic arch and/or its branches (18.6%); and Cluster 3: combined involvement of Cluster 1 and 2 (53.9%). Clinical characteristics, especially hypertensive severity, differed greatly among three imaging clusters. In all, 187 patients were followed-up for a median of 46 (9-102) months; 127 (67.9%) cases did not experience any events, while 72 events were observed in 60 patients. The overall blood pressure control rate was 50.8%, and the EFS was 67.9% by the end of the follow-up. Multivariate Cox regression indicated that controlled blood pressure (HR = 2.13, 95% CI 1.32–3.74), Cluster 1 (HR = 0.69, 95% CI 0.48–0.92) and Cluster 3 (HR = 0.72, 95% CI 0.43–0.94) imaging phenotype was associated with the EFS. Kaplan–Meier curves showed that patients with controlled blood pressure showed better EFS (p = 0.043). Furthermore, patients had controlled blood pressure and Cluster 1 phenotype was set as reference, better EFS was observed in patients with controlled blood pressure and Cluster 2 phenotype (HR = 2.21, 95%CI 1.47–4.32), while those had uncontrolled blood pressure and Cluster 1 phenotype (HR = 0.64, 95%CI: 0.52–0.89) and those had uncontrolled blood pressure and Cluster 3 phenotype (HR = 0.83, 95%CI: 0.76–0.92) suffered worse EFS.
Conclusion
Blood pressure control status and imaging phenotypes showed significant effects on the EFS for hypertensive TAK.
Figure 1
Figure 2
Figure 3
Figure 4
Figure 5
This is a list of supplementary files associated with this preprint. Click to download.
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