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Imaging characteristics and prognostic factors of Behcet's disease with arterial involvement: A long-term follow-up
Yu-Ling Qian1, Rui-Lin Quan1, Xiao-Xi Chen1
1Department of Pulmonary Vascular Disease, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, State Key Laboratory of Cardiovascular Disease, 100037 Beijing, China.
Insights
This study reveals that cardiac involvement and pulmonary artery aneurysm/dilation significantly impact long-term survival in Behcet's disease (BD) patients with arterial issues. Early identification of these factors is crucial for managing arterial complications in BD.
Area of Science:
- Vascular Medicine
- Rheumatology
- Medical Imaging
Background:
- Behcet's disease (BD) is a multisystem inflammatory disorder.
- Arterial involvement is a serious complication of BD, affecting prognosis.
- Understanding imaging features and prognostic factors is vital for patient management.
Purpose of the Study:
- To characterize the imaging findings of arterial involvement in Behcet's disease.
- To identify prognostic factors influencing long-term survival in these patients.
Main Methods:
- Retrospective analysis of 84 Behcet's disease patients with arterial involvement (2003-2020).
- Arterial lesions assessed using ultrasonography, arteriography, and/or CT angiography.
- Cox proportional hazards regression used to determine prognostic factors.
Main Results:
- Most patients (73.8%) were male; arterial involvement occurred early in 33.3%.
- Multiple arteries were involved in 94% of cases; aneurysm/dilation common in aorta, stenosis/occlusion in coronary arteries.
- 5- and 10-year survival rates were 87.4% and 84.1%, respectively.
- Cardiac involvement (HR: 4.34) and pulmonary artery aneurysm/dilation (HR: 4.89) were independent mortality predictors.
Conclusions:
- Arterial lesions in BD are often multifocal and vary by artery type.
- Cardiac involvement and pulmonary artery aneurysm/dilation are key independent prognostic factors for mortality in BD patients with arterial disease.
Purpose:
To investigate the imaging characteristics and prognostic factors for the long-term survival of Behcet's disease (BD) with arterial involvement.
Methods:
In this retrospective study, BD patients with arterial involvement were identified from January 2003 to January 2020. Arterial lesions were detected by ultrasonography, traditional arteriography, and/or computed tomography angiography (CTA). Cox proportional hazards regression analyses were performed to identify the prognostic factors.
Results:
Totally, 84 BD patients with arterial involvement were identified (73.8 % males). The mean age at BD diagnosis was 39.1 ± 13.1 years. Arterial involvement was the initial manifestation in 33.3 % of the patients, and the median time from BD diagnosis to arterial involvement was 6 (IQR 1-15.5) years for the rest of patients. Systemic artery involvement and pulmonary artery involvement (PAI) were found in 64 and 27 patients, respectively. Approximately 94.0 % (79/84) of the patients had more than one artery involved concurrently or successively during the course of BD. Aneurysm/dilation was the most prevalent lesion in the aorta (76.0 %), while stenosis/occlusion was the main lesion of the coronary artery (90.9 %) and other aortic branches (74.5 %). Pulmonary hypertension was found in 70.4 % (19/27) of patients with PAI. The 5- and 10-year survival rates of BD patients with arterial involvement were 87.4 % and 84.1 %, respectively. Cardiac involvement (HR: 4.34) and pulmonary artery aneurysm/dilation (HR: 4.89) were independently associated with mortality.
Conclusions:
Arterial lesions associated with BD usually involve multiple arteries and manifest differently in different types of arteries. Cardiac involvement and pulmonary artery aneurysm/dilation are independent prognostic factors of BD patients with arterial involvement.
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