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ORIGINAL ARTICLE

Patients with Behcet's disease carry a higher risk for microvascular involvement in active disease period

, , , , , , , & show all
Pages 154-159 | Received 03 Aug 2006, Accepted 08 Jan 2007, Published online: 08 Jul 2009
 

Abstract

Background. Behcet's disease (BD) is characterized with remissions and exacerbations. However, to date, there is no study to investigate a possible association of disease activity (active versus inactive disease period) with cardiovascular complications.

Methods. Forty patients with BD were evaluated in both active and in inactive disease period. For the control group 45 healthy volunteers, age and sex matched, were registered. Subjects with at least a 15‐day lesion‐free period were regarded in inactive disease period, and subjects with any oral, skin, and/or genital lesion was regarded as in active disease period. In each subject coronary diastolic peak flow velocities (DPFV) were measured at baseline and after dipyridamole infusion (0.84 mg/kg over 6 minutes) using an Acuson Sequoia C256® echocardiography system. Coronary flow reserve (CFR) was defined as the ratio of hyperemic to baseline DPFV.

Results. CFR values were significantly lower in BD patients compared to the controls (2.57±0.50 versus 2.87±0.53, P = 0.006). In active disease period, basal DPFV (24.6±7.5 versus 27.3±6.6, P = 0.019) was significantly higher than in the inactive disease period. In the active disease period hyperemic DPFV (61.7±14.9 versus 56.8±16.7, P = 0.015) values decreased significantly. Therefore, in the active disease period CFR significantly decreased from 2.57±0.50 to 2.09±0.46, P<0.001. The only independent predictor of CFR within the active disease period was the disease duration (β = −0.384, P = 0.012).

Conclusion. Within the active disease period, coronary microvascular function is more prominently impaired in BD patients. Therefore, BD patients are possibly more vulnerable to cardiovascular manifestations when they are in an active disease period.

Abbreviations
BD=

Behcet's disease

TDHE=

transthoracic second harmonic Doppler echocardiography

LAD=

left anterior descending coronary artery

CFR=

coronary flow reserve

hsCRP=

high‐sensitivity C‐reactive protein

ESR=

ERYTHROCYTE SEDIMENTATION RATE

BMI=

body mass index

HDL=

high‐density lipoprotein

LDL=

low‐density lipoprotein

DPFV=

diastolic peak flow velocity

NO=

nitric oxide

Abbreviations
BD=

Behcet's disease

TDHE=

transthoracic second harmonic Doppler echocardiography

LAD=

left anterior descending coronary artery

CFR=

coronary flow reserve

hsCRP=

high‐sensitivity C‐reactive protein

ESR=

ERYTHROCYTE SEDIMENTATION RATE

BMI=

body mass index

HDL=

high‐density lipoprotein

LDL=

low‐density lipoprotein

DPFV=

diastolic peak flow velocity

NO=

nitric oxide

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