Increased epicardial adipose tissue thickness on transthoracic echocardiography in patients with Behçet disease

Owing to the fact that the potential frequency of endothelial dysfunction and early atherosclerosis might be higher in Behçet disease, characterized by acute and chronic inflammatory attacks, it may lead to impairment in flow-mediated dilatation and an increase in epicardial adipose tissue thickness. Therefore, we aimed to evaluate whether epicardial adipose tissue thickness and brachial artery flow-mediated dilatation as markers of early atherosclerosis and endothelial dysfunction were associated with Behçet disease.

Thirty-five patients with Behçet disease and 35 healthy volunteers were included in this study. Epicardial adipose tissue was identified as an anechoic space between epicardial layers on 2-dimensional images, and its thickness was measured on the free wall of the right ventricle. Right brachial artery flow-mediated dilatation was assessed according to recent guidelines.

Serum γ-glutamyl transferase (GGT) levels and epicardial adipose tissue thickness were significantly higher (P = .001; P < .001 respectively), whereas flow-mediated, endothelium-dependent dilatation was significantly lower in the Behçet disease group than controls (P < .001). There was a significant negative association between epicardial adipose tissue thickness and flow-mediated dilatation (P < .001). Epicardial adipose tissue thickness was also positively correlated with Behçet disease activity (P< .001), Behçet disease duration (P< .001), and waist circumference (P< .001). Flow-mediated dilatation was negatively correlated with GGT (P< .001), Behçet disease activity (P< .001), and age (P< .001). There was also a significant association between GGT and Behçet disease activity (P < .001).

We found that epicardial adipose tissue thickness was significantly higher and flow-mediated dilatation was significantly lower in patients with Behçet disease than in controls. We suggest that identification of increased epicardial adipose tissue might aid in the diagnosis and treatment of possible coronary artery disease in patients with Behçet disease.