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Published on: October 15, 2010
Evaluation of endothelial function in patients with Behçet's disease in remission: A cross-sectional study
Fernanda Mendonça Rodrigues1, Ana Beatriz Bacchiega1, Bruno Cesar Bacchiega2
1Department of Rheumatology, Rio De Janeiro State University, Rio De Janeiro, Brazil.
Insights
Patients with Behcet's disease (BD) in remission may have endothelial dysfunction, indicated by lower flow-mediated dilation (FMD) trends. Further research is needed to confirm these findings in cardiovascular risk assessment.
Area of Science:
- Cardiovascular Medicine
- Rheumatology
- Vascular Biology
Background:
- Endothelial dysfunction is an early sign of atherosclerosis and a predictor of cardiovascular risk.
- Behcet's disease (BD) is linked to endothelial dysfunction, but its impact on atherosclerosis progression during remission is unclear.
Purpose of the Study:
- To investigate endothelial function in patients with Behcet's disease (BD) in clinical remission.
- To assess the potential link between chronic vascular inflammation in BD and atherosclerosis development.
Main Methods:
- A cross-sectional study involving 12 patients with BD in remission and 12 matched controls.
- Flow-mediated dilation (FMD) was used to evaluate endothelial function.
Main Results:
- The BD group exhibited a lower median FMD (2.025%) compared to controls (5.46%), suggesting a trend towards endothelial dysfunction (P=.18).
- Median total cholesterol was significantly lower in the BD group (168 mg/dL) than in controls (216.5 mg/dL) (P=.0193).
- Intima-media thickness measurements did not differ significantly between BD patients and controls in either carotid artery.
Conclusions:
- A trend towards endothelial dysfunction was observed in BD patients during remission, despite clinical stability.
- Limitations include a small sample size and potential confounding factors like statin use in the BD group.
Objective:
Endothelial dysfunction is an initial stage of the atherogenic process, which can be evaluated by a noninvasive method (flow-mediated dilation - FMD) and has a well-established prognostic value for cardiovascular (CV) risk. Currently, there is no evidence of increased CV mortality in Behc¸et's disease (BD), although its association with endothelial dysfunction has been described. There are still doubts in the literature whether the presence of chronic vascular inflammation might trigger the development of atherosclerosis, despite BD remission, which is why this study was conducted.
Methods:
We analyzed 24 subjects in this cross-sectional study (12 patients with BD in remission and 12 subjects matched by gender age). Endothelial function was analyzed via FMD.
Results:
The lowest median for FMD was presented by the BD group (2.025% - interquartile range (IQR) 7.785 versus 5.46% - IQR 3.625, P ¼ .18). The median total cholesterol in the BD group was lower than the controls (168 mg dL-1 - IQR 46 and 216.5 mg dL-1 - IQR 54, respectively, P ¼ .0193). In the right carotid artery, the intima-media thickness was equal to 0.740 - IQR 0.16 for the patients and 0.740 - IQR 0.11 for the controls (P ¼ .9473); on the left, 0.725 - IQR 0.13 and 0.745 - IQR 0.120 (P ¼ .4333), respectively.
Conclusion:
The lower median trend of FMD in patients with BD suggests endothelial dysfunction, despite clinical remission of the inflammatory disease, although our study is limited by the sample size and greater use of statins in BD group.
