[Prognosis of giant cell arteritis].
CHU de Nantes, pôle médecine-cancer-hématologie, hôpital Hôtel-Dieu, centre de compétence maladies systémiques et auto-immunes rares, service de médecine interne, 44093 Nantes cedex 01, France. Electronic address: . La Presse Médicale
(Impact Factor: 1.08).
The short-term prognosis of giant cell arteritis is associated to the risk of permanent visual loss, concerning 5-20% of patients, and mainly secondary to anterior ischaemic optic neuropathy. Most studies have suggested that long-term survival, around 80% at 5 years, is not impaired in giant cell arteritis. However, increased mortality has been often noticed in the year following diagnosis, especially related to cardiovascular disorders including aortitis (10-20% of cases), stroke (5-10% of cases), or myocardial infarction, commonly associated to atherosclerosis and to arterial hypertension. Aortic dissections or aneurysm ruptures are causes of death, which can therefore be directly related to the vasculitis. Most of the patients develop steroid related complications: infections that may lead to death, or osteoporosis in 20-40% of cases with a better prognosis than before thanks to preventive treatments.
Available from: Aluísio Henrique Rodrigues de Andrade Lima
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ABSTRACT: Patients with arteritis have a high risk of mortality from cardiovascular disorders. However, whether these patients benefit from an intervention involving exercise remains unclear. In this study, we assessed the effects of an unsupervised exercise program on walking capacity, quality of life, and cardiovascular parameters of a patient with arteritis. A 33-yearold man reporting symptoms of claudication during walking was studied. Imaging tests revealed severe atherosclerosis and arteritis was diagnosed. Five weekly sessions of walking for 16 weeks increased claudication distance and total walking distance, produced improvements in six out of the eight health-related quality-of-life domains, decreased systolic blood pressure, and changed cardiac autonomic modulation toward parasympathetic modulation. This case report showed that unsupervised exercise training improved walking capacity, quality of life, and cardiovascular parameters in a patient with arteritis.
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