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Alterations in left ventricular function in patients with Behçet's disease using radionuclide ventriculography and
1Department of Internal Medicine, Hacettepe University, Ankara, Turkey.
Insights
Cardiac involvement in Behçet
Area of Science:
- Cardiology
- Rheumatology
- Medical Imaging
Background:
- Behçet's disease is a multisystem disorder.
- Cardiac involvement is often unrecognized clinically.
- Early detection of cardiac issues is crucial.
Purpose of the Study:
- To assess left ventricular systolic and diastolic function in Behçet's disease patients.
- To evaluate the utility of noninvasive imaging in detecting subclinical cardiac abnormalities.
Main Methods:
- Radionuclide ventriculography (RVG) using 99mTc-labeled red blood cells.
- Doppler echocardiography (DE) for mitral flow analysis.
- Analysis of ejection fraction (EF), peak filling rate (PFR), and ventricular compliance.
Main Results:
- Patients showed significantly lower mean EF, EFV, PFR, and 1/3 FF compared to controls.
- RVG revealed diastolic dysfunction in 37.5% and systolic dysfunction in 12.5% of patients.
- DE indicated abnormal ventricular compliance in 13.6% of patients.
Conclusions:
- Noninvasive imaging methods like RVG and DE can detect early cardiac involvement in Behçet's disease.
- Diastolic impairment is a key early sign of cardiac involvement.
- These methods aid in identifying subclinical cardiac disorders.
Abstract:
Behçet's syndrome is a multisystem disease; however, cardiac involvement in this disorder has been relatively less recognized. Noninvasive imaging methods may reveal a cardiac disorder which has not manifested itself clinically. In this study, radionuclide ventriculography and Doppler echocardiography were performed in 24 patients with Behçet's disease to assess the left ventricular systolic and diastolic function. Patients had neither known heart disease nor cardiac symptoms. Radionuclide ventriculography was performed using 99mTc-labeled red blood cells. Ejection fraction (EF), EF fraction in the first 100 ms (EFV), peak ejection rate, time to peak ejection, 1/3 EF, time to end systole, peak filling rate (PFR), time to peak filling and 1/3 filling fraction (1/3 FF) values were computed using Fourier analysis of the time activity curve of the left ventricle with 3 harmonics. Doppler echocardiography (DE) has described impairment of diastolic compliance using analysis of mitral flow. The mean EF (54.7 +/- 9%), EFV (11.6 +/- 3.6%), PFR (2.49 +/- 0.58 EDC/s) and 1/3 FF (33.64 +/- 14%) values were significantly lower in patients than those of the control group. Nine (37.5%) patients demonstrated an impairment of diastolic function and 3 (12.5%) had abnormal systolic function observed by the radionuclide method. DE showed abnormal ventricular compliance in 13.6% of patients. As a conclusion, noninvasive imaging methods such as radionuclide ventriculography and DE may be valuable to detect diastolic impairment as an early sign of cardiac involvement in Behçet's disease.