Carotid artery intima-media thickness in Behcet's disease patients without significant cardiovascular involvement

Abstract

Background/Aims : Behcet's disease (BD) is a systemic disorder associated with a characteristic vasculitis that can involve both veins and arteries of all sizes. Endothelial activation or injury is a characteristic feature of BD. Endothelial dysfunction is widely regarded as being the initial lesion in the development of atherosclerosis. The carotid artery intima-media thickness (IMT) is a widely accepted marker of subclinical atherosclerosis. We aimed to determine the carotid IMT in BD patients with using high-resolution B-mode Doppler ultrasonography.Methods : We studied 40 patients (24 males, mean age: 39.1±8.5 years) who were diagnosed by the international diagnostic criteria of Behcet's disease and 20 healthy controls (13 males, mean age: 40.2±5.1 years), and the two groups were matched by age and gender. No subject in either group had a history of atherosclerosis or its complications. The clinical data, including the age of onset, the duration of disease, a history of medication, the activity score and the laboratory data were analyzed.Results : The carotid IMT in the BD group was significantly higher than that in the control group (0.71±0.22 mm vs. 0.59±0.09 mm, respectively, p<0.01). Cardiac and major vessel involvements were not identified in the BD group. However, minor vascular involvements were documented in 2 patients with deep vein thrombosis, in 4 patients with superficial thrombophlebitis and in 2 patients with pseudoaneurysm. The carotid IMT in the patients with posterior uveitis or retinal vasculitis was higher than that of the patients without these findings (0.85±0.21 mm vs. 0.64±0.10 mm, respectively, p=0.007), but there was no difference of the IMT according to minor vascular involvement.Conclusions : Despite that there was no significant cardiovascular involvement in the BD patients, the carotid IMT was significantly higher in the BD patients as compared with the healthy controls.

Subclinical Atherosclerosis in Behçet’s Disease

“…The carotid artery IMT is a widely accepted marker of subclinical atherosclerosis. [2] Subclinical increased IMT: In the present study, IMT was significantly increased in the patients with BD. Similarly, it was notably higher in these patients when compared with the controls.…”

“…This occurred despite there being no significant cardiovascular involvement. [2,15] Endothelial dysfunction occurs before visible structural changes of the arterial wall [7] and represents a key event in subclinical atherosclerosis in BD. [16] Our study showed that IMT increases in patients with hepatitis.…”

“…[1] Patients with Behçet᾽s disease who have major vessel involvement have a poor prognosis. [2] Large vessel involvement is more common in the venous system. [3] Arterial involvement is rarely described in BD, but the outcome is usually not good.…”

Carotid artery stiffness in Behçet’s disease

“…cIMT has been reported to be high in some studies on BD (13,(25)(26)(27)(28). However, this high value has not been detected in other studies (14, 29-31).…”

Dilated Cardiomyopathy in Behcet′s Disease in a Young Male Patient

“…Cardiac involvement in BD is known as cardio-Behcet's disease that occurs in 7% to 31% of patients with BD, with a mortality rate of 20% [3]. Cardiac manifestations in BD include endocarditis, myocarditis, pericarditis, intracardiac thrombus, endomyocardial fibrosis, coronary arterial disease, cardiomyopathy, myocardial infarction, valvular disease, diastolic dysfunction, ventricular arrhythmias, and sudden cardiac death [4].…”