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The risk of cardiovascular comorbidity in children with Behçet's disease
Selcan Demir1, Ali Duzova2, Tevfik Karagoz3
1Department of Pediatric Rheumatology, Eskisehir Osmangazi University Medical Faculty, Eskisehir, Turkey.
Insights
Cardiovascular risks in pediatric Behçet's disease (BD) patients were assessed. While some indicators were similar, vascular involvement showed potential aortic stiffness, suggesting comprehensive cardiovascular evaluation for all pediatric BD patients is crucial.
Area of Science:
- Pediatric Rheumatology
- Cardiovascular Medicine
- Vascular Biology
Background:
- Behçet's disease (BD) can lead to significant long-term cardiovascular morbidity in pediatric patients.
- Assessing cardiovascular comorbidity risk in pediatric BD is essential, particularly differentiating between patients with and without vascular involvement.
- Traditional cardiovascular risk factors were excluded to isolate BD-specific impacts.
Purpose of the Study:
- To evaluate cardiovascular comorbidity risk in pediatric BD patients.
- To compare cardiovascular risk markers in pediatric BD patients with and without vascular involvement.
- To determine the utility of ambulatory blood pressure monitoring (ABPM) in assessing cardiovascular risk in pediatric BD.
Main Methods:
- Included 31 pediatric BD patients meeting 2015 PEDBD criteria.
- Utilized 24-hour ambulatory blood pressure monitoring (ABPM), transthoracic echocardiography, and carotid intima-media thickness (cIMT) measurements.
- Excluded patients with active disease or other known cardiovascular risk factors.
Main Results:
- 10 out of 31 (34.4%) pediatric BD patients exhibited abnormal ABPM.
- No significant differences in ABPM parameters or cIMT were found between patients with and without vascular involvement.
- Echocardiography revealed increased left ventricle outflow tract velocity and velocity time integral in BD patients with vascular involvement, suggesting potential aortic stiffness.
Conclusions:
- Pediatric BD patients with vascular involvement may present with increased cardiovascular risk factors.
- Comprehensive cardiovascular assessment is recommended for all pediatric BD patients, irrespective of specific system involvement.
- Ambulatory blood pressure monitoring (ABPM) shows promise for accurately defining hypertension and cardiovascular risk in pediatric BD.
Objective:
Patients with Behçet's disease (BD) may experience long-term morbidity caused by various forms of cardiovascular disease. This study aimed to assess the risk for cardiovascular comorbidity in paediatric BD patients with and without vascular involvement, independent of the contribution of traditional risk factors.
Methods:
Paediatric patients classified as having BD according to the 2015 Peadiatric BD (PEDBD) criteria were included in the study. Twenty-four-hour ambulatory blood pressure monitoring (ABPM), transthoracic echocardiography, and carotid intima-media thickness (cIMT) measurements were performed. Patients with an active disease or those who have other known risk factors for cardiovascular disease were not included in the study.
Results:
Thirty-one children and adolescents with paediatric BD (16 female, 51.6%; F/M: 1.06) were enrolled in the study. Among the BD patients, 10 patients (34.4%) had abnormal ABPM. Carotid IMT values, mean arterial pressure, systolic and diastolic blood pressure by ABPM and the prevalence of abnormal ABPM, non-dipping, and ambulatory hypertension were similar between patients with and without vascular involvement. The echocardiography measurements showed that BD patients with vascular involvement had a significantly higher velocity and velocity time integral of the left ventricle outflow tract, which may indicate increased stiffness of the aorta.
Conclusion:
Paediatric BD patients with vascular involvement may tend to have more cardiovascular risk factors. However, cardiovascular assessment should be considered in all BD patients, regardless of the involved systems. We suggest that ABPM may accurately define hypertension and cardiovascular risk in BD.
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