• Sophie Gallou, Christian Agard, Anael Dumont, Samuel Deshayes, Jonathan Boutemy, Gwénola Maigné, Nicolas Martin Silva, Alexandre Nguyen, Rémi Philip, Olivier Espitia, Achille Aouba, and Hubert de Boysson.
• Department of Internal Medicine, Caen University Hospital, Caen, France; University of Caen Normandie, Caen, France.
• Eur. J. Intern. Med. 2024 Apr 5.

ObjectivesTo identify factors associated with the progression of giant cell arteritis (GCA)-related or associated aortic dilations.MethodsIn this retrospective study, 47 GCA patients with aortic dilation were longitudinally analyzed. Each patient underwent ≥2 imaging scans of the aorta during the follow-up. Three progression statuses of aortic dilations were distinguished: fast-progressive (FP) defined by a progression of the aortic diameter ≥5 mm/year or ≥1 cm/2 years, slow progressive (SP) by a progression of the aortic diameter >1 mm during the follow-up, and not progressive (NP) when aortic diameter remained stable.ResultsAmong the 47 patients with aortic dilation, the thoracic section was involved in 87 % of patients. Within a total follow-up of 89 [6-272] months, we identified 13 (28 %) patients with FP dilations, and 16 (34 %) and 18 (38 %) patients with SP and NP dilations, respectively. No differences regarding baseline characteristics, cardiovascular risk factors or treatments were observed among the 3 groups. However, FP patients more frequently showed atheromatous disease (p = 0.04), with a more frequent use of statins (p = 0.04) and antiplatelet agents (p = 0.02). Among the 27 (57 %) patients with aortitis, aortic dilation developed on an inflammatory segment in 23 (85 %). Among the FP patients who underwent aortic surgery with available histology (n = 3), all presented active vasculitis.ConclusionThis study suggests that aortic inflammation, as well as atheromatous disease, might participate in the fast progression of aortic dilation in GCA.Copyright © 2024. Published by Elsevier B.V.

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