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In Vivo Quantitative Assessment of Myocardial Structure, Function, Perfusion and Viability Using Cardiac Micro-computed Tomography
Published on: February 16, 2016
Evaluation of myocardial perfusion in patients with Behçet's disease
Seyda Türkölmez1, Nahide Gökçora, Mehmet Alkan
1Department of Nuclear Medicine, Ankara Education Hospital, Ankara, Turkey. sturkolmez@yahoo.com
Insights
Silent myocardial ischemia (SMI) is prevalent in Behçet's disease (BD) patients. Screening is recommended for BD patients with over 10 years of disease duration, especially males, to detect SMI early.
Area of Science:
- Cardiology
- Rheumatology
- Diagnostic Imaging
Background:
- Behçet's disease (BD) is a multisystem inflammatory disorder.
- Cardiovascular involvement, including silent myocardial ischemia (SMI), is a potential complication in BD.
- Prevalence and risk factors for SMI in BD patients require further investigation.
Purpose of the Study:
- To determine the prevalence of SMI in patients diagnosed with Behçet's disease.
- To identify specific patient subgroups within the BD population who are at increased risk for SMI.
Main Methods:
- A cohort of 41 BD patients and 35 healthy controls underwent treadmill exercise testing and thallium-201 myocardial perfusion SPECT.
- Coronary angiography was performed for BD patients diagnosed with SMI.
- Statistical analysis was used to compare SMI prevalence and identify risk factors.
Main Results:
- Silent myocardial ischemia (SMI) was detected in 19.5% of BD patients, compared to 2.9% in controls.
- No significant coronary stenosis was found in SMI-positive BD patients via angiography.
- A longer duration of BD (over 10 years) was significantly associated with SMI (p < 0.001).
Conclusions:
- The prevalence of SMI is notably high among patients with Behçet's disease.
- Myocardial perfusion scintigraphy screening is advisable for BD patients with a disease duration exceeding 10 years.
- Early detection of SMI in BD patients can guide timely cardiovascular risk management.
Aim:
To estimate the prevalence of silent myocardial ischemia (SMI) in patients with Behçet's disease (BD) and to identify a subgroup of patients at higher risk for the presence of SMI.
Materials And Methods:
We evaluated 41 patients (mean age 42.8 +/- 12.3 years) with BD and 35 healthy control subjects. Treadmill exercise test and thallium-201 myocardial perfusion single photon emission computed tomography (SPECT) were performed in all subjects. Coronary angiography was performed in all patients with a diagnosis of SMI in Behçet's group.
Results:
All subjects had normal resting electrocardiograms. Eight patients with BD (19.5%) had evidence of ischemia on exercise testing and myocardial perfusion SPECT. Only one SMI positivity (2.9%) was recorded in the control group. Significant coronary stenosis was not found with coronary angiography in the patients with a diagnosis of SMI in Beçet's group. SMI positivity was recorded in 2 of 18 female patients (11%) and in 6 of 23 male patients (26.1%) with BD (p = 0.429). The mean duration of BD was 13.8 +/- 2.6 years in patients with SMI and 7 +/- 4.1 in patients without it (p < 0.001). Seven of the 8 patients (87.5%) with SMI had a duration of BD of greater than 10 years.
Conclusions:
The results of this study show that the prevalence of SMI is high in patients with BD. Based on our findings, screening with myocardial perfusion scintigraphy may be recommended for patients with duration of BD greater than 10 years.
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