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Cardiac magnetic resonance imaging in patients with Behçet's disease

Ali A Ahmed¹, Samar Tharwat², Nihal M Batouty³

¹Rheumatology and Immunology Unit, Internal Medicine Department, Faculty of Medicine, Mansoura University Hospital, Mansoura University, El Gomhouria St, Mansoura, Dakahlia Governorate, Egypt.

Advances in Rheumatology (London, England)

|December 8, 2021

Insights

Behçet

Area of Science:

Cardiovascular Imaging
Rheumatology
Vasculitis Research

Background:

Behçet's disease (BD) is a systemic vasculitis with potential cardiac implications.
Cardiac involvement in BD is not well-characterized, necessitating further investigation.
Understanding cardiac manifestations is crucial for comprehensive BD patient management.

Purpose of the Study:

To investigate the cardiac magnetic resonance imaging (MRI) findings in patients with Behçet's disease.
To delineate the spectrum and incidence of cardiac abnormalities associated with BD.
To explore the relationship between BD activity and cardiac involvement.

Main Methods:

A cross-sectional observational study involving 30 BD patients without prior cardiac disease.
Standard clinical assessments including history, physical examination, and echocardiography were performed.
Cardiac MRI was utilized to evaluate cardiac structure and function in all participants.

Main Results:

Cardiac abnormalities were detected in 66.67% of BD patients via cardiac MRI.
Observed abnormalities included myocardial edema, pericardial effusion, ventricular dysfunction, and valve regurgitation.
Higher BD activity index scores significantly predicted the presence of cardiac abnormalities.

Conclusions:

Behçet's disease can lead to subclinical cardiac abnormalities.
Cardiac MRI is a valuable tool for early detection of cardiac involvement in BD.
Disease activity is a key factor associated with cardiac complications in BD.

Read full analysis

Abstract

Background:

Behçet's disease (BD) is a multisystemic vasculitis that may affect the heart. However, the incidence and nature of cardiac involvement in BD have not been clearly documented yet. The aim of this study was to delineate the cardiac magnetic resonance imaging (MRI) appearances of cardiac involvement in BD patients.

Methods:

This cross-sectional observational study was carried out 30 BD patients without known cardiac disease. Patients were subjected to history taking, physical examination, echocardiography and cardiac MRI.

Results:

At least one abnormality on cardiac MRI was observed in 20/30 patients (66.67%). Myocardial oedema was observed in 3 patients (10%) and late gadolinium enhancement in 1 patient (3.3%). Pericardial effusion was found in 3 patients (10.0%), global hypokinesia in 6 patients (20.0%) and intra-cardiac thrombosis in only 1 patient (3.3%). Pulmonary artery was dilated in 4 patients (13.3%). Left ventricular (LV) and right ventricular (RV) end diastolic volume were altered in 4 patients (13.3%) and 7 patients (23.3%) respectively. LV and RV end systolic volume were abnormal in 7 patients (23.3%) and 5 patients (16.7%) respectively. There was aortic valve regurge in 2 patients (6.7%), tricuspid valve regurge in 9 patients (30%), and mitral valve regurge in 9 patients (30%). Dilated left main coronary artery was found in 2 patients (6.7%) and arrhythmogenic right ventricular dysplasia in only one patient 1 patient (3.3%). On logistic regression analysis, BD activity index score was a significant predictor of cardiac abnormalities.

Conclusion:

BD may cause cardiac abnormalities without clinical manifestations and cardiac MRI may represent a tool for early detection of these subtle abnormalities. Higher BD activity index scores are strongly linked to cardiac problems.

Keywords:

Behçet’s disease Cardiac MRI Heart

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