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Cardiovascular involvement in Behçet's disease
Cemil Gürgün1, Ertugrul Ercan, Ceyhun Ceyhan
1Department of Cardiology, Ege University Medical School, Ege University Medical School, Bornova, Izmir, Turkey.
Insights
Cardiac involvement in Behçet
Area of Science:
- Cardiology
- Rheumatology
- Internal Medicine
Background:
- Cardiac involvement in Behçet's disease is not well-documented.
- Behçet's disease is a multisystem inflammatory disorder with potential cardiovascular complications.
Purpose of the Study:
- To define the incidence and nature of cardiac involvement in Behçet's disease.
- To investigate cardiac structural and electrical abnormalities using echocardiography and electrocardiography.
Main Methods:
- 35 Behçet's disease patients and 30 controls underwent transthoracic/transesophageal echocardiography and ECG.
- Evaluated for interatrial septum aneurysm, mitral valve prolapse, mitral regurgitation, and aortic dilatation.
- Assessed QT dispersion and signal-averaged ECG for ventricular repolarization abnormalities.
Main Results:
- Behçet's patients showed higher incidences of interatrial septum aneurysm (31%), mitral valve prolapse (25%), mitral regurgitation (40%), and aortic dilatation.
- Significantly greater mean QT dispersion and corrected QT dispersion were observed in Behçet's patients.
- Positive signal-averaged ECG parameters (late potentials) were found in 51% of Behçet's patients vs. 3% of controls.
Conclusions:
- Cardiac involvement in Behçet's disease is common, involving structural changes like aortic and valvular abnormalities.
- Increased QT dispersion and positive late potentials indicate diffuse cardiac involvement and repolarization disturbances.
- Echocardiography and ECG are crucial for detecting cardiac manifestations in Behçet's disease.
Abstract:
The incidence and nature of cardiac involvement in Behçet's disease are not yet clearly documented. We first used transesophageal echocardiography in combination with resting and signal averaged electrocardiography to define cardiac involvement in Behçet's patients. Transthoracic and multiplane transesophageal echocardiography, and resting and signal averaged electrocardiography were performed in 35 Behçet's disease patients (9 women and 26 men, mean age: 38 +/- 12 years) and 30 normal subjects. Higher incidences of interatrial septum aneurysm (31% to 6%), mitral valve prolapse (25% to 3%), mitral regurgitation (40% to 6%) and aneurysmal dilatations of sinus valsalva and ascendan aorta were observed in the Behçet's disease patients than in the normal subjects. Mean QT dispersion and mean corrected QT dispersion values were significantly greater in the patients with Behçet's disease. Patients with interatrial septum aneurysm (and/or PFO), valvular dysfunction or proximal aorta dilatation had greater QT dispersion values than thase without these pathologies in the Behçet's group (63 +/- 11 vs 44 +/- 19 ms, 58 +/- 23 vs 41 +/- 24 and 60 +/- 27 vs 42 +/- 23 ms respectively, P<0.05). Positive signal averaged electrocardiography parameters were detected in 18 (51%) Behçet's disease patients compared with one (3%) in controls (P<0.001). Dilatation of the proximal aorta, interatrial septal aneurysm, mitral valve prolapse, and mitral regurgitation are the common findings of cardiac involvement in Behçet's disease. Increased dispersion of ventricular repolarisation and positive late potentials are also detected. QT dispersion is significantly higher in patients with these cardiac abnormalities. These findings suggest that cardiac involvement in this disorder is a diffuse process which involves both cardiac structure and vascular elements.