Vasculitis & polymyalgia rheumatica
The influence of the cardiac cycle on the halo sign and its impact on the ultrasound diagnosis of giant cell arteritis
Authors' conclusion
IMT can fluctuate during the cardiac cycle, with higher measurements occurring at ED. This variability could potentially impact the accuracy of US diagnoses and assessments of GCA.
Study context
- Population
- 100 consecutive patients with US performed between January 2021 and June 2023 (50 with GCA, 50 without)
- Participants
- 100 patients
- Exposure
- Intima-media thickness (IMT) at systolic peak vs end-diastole, in patients with and without GCA
- GCAn = 50
- Non-GCAn = 50
- Outcome
- Difference between IMT at systolic peak (SP) and at end-diastole (ED) of temporal, axillary and subclavian arteries
Methodological detailsconsecutive patients, US videos reviewed
- Consecutive patients
- US videos reviewed
Main finding
As reported in the abstract
IMT at ED vs SP
IMT significantly higher at end-diastole (ED) in all arteries, in both GCA and non-GCA groups
4.8-5%
Observational data: associations, not effects.
Further findings
- Halo count (HC) positive in ED and negative in systolic peak (SP) (non-GCA) — Non-GCA
- 8%
- HC modified by cardiac cycle timing (GCA)
- 28% · 14 of 50
Halo count and OMERACT GCA Ultrasonography Score (OGUS) at ED vs SP
- HC and OGUS higher in ED in both groups
HC positive in ED and negative in SP (non-GCA)
- In all of them the HC in ED was 1
HC modified by cardiac cycle timing (GCA)
- Cardiac cycle timing did not influence the final US diagnosis in the GCA group
Original publication
The influence of the cardiac cycle on the halo sign and its impact on the ultrasound diagnosis of giant cell arteritis. Rheumatology (Oxford). Published 17 May 2024. doi:10.
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