Evaluation of left ventricular diastolic dysfunction with conventional and current Doppler techniques in Behcet’s disease

Abstract

Behcet's disease (BD) is a systemic vasculitis characterized by genital and oral ulcers, uveitis, and other organs' involvement. Left ventricular (LV) diastolic dysfunction has been documented in BD. However, conventional echocardiographic techniques have serious limitations like its dependence on preload, afterload and heart rate. Recently, new techniques like colour M-mode and tissue Doppler imagining (TDI) have provided additional concept in the assessment of diastolic function. The aim of the present study was to investigate the LV diastolic dysfunction with conventional and new echocardiographic techniques in BD. Forty-eight patients with BD (25 women, 23 men) and 26 healthy volunteers (15 women, 11 men) were enrolled in the study. LV diastolic functions were examined with mitral inflow pulse wave Doppler, TDI and mitral flow propagation rate (MFPR). The following were accepted as diastolic dysfunction: in mitral inflow pulse wave Doppler, E/A<1, isovolumic relaxation time (IVRT)>110 ms and deceleration time of E wave (DT)>240 ms; in TDI of mitral ring with pulse wave, E'/A'<1; and in MFPR, velocity slope (Vp)<45 cm/s. The two groups were comparable in age, sex, heart rate, body mass index, smoking, hyperlipidemia and basic echocardiographic measurements. LV diastolic dysfunction was significantly higher in BD group according to E/A<1 (p<0.05). When echocardiographic measurements were compared one by one for two groups, As' (late diastolic TDI wave in septal wall) was found to be significantly higher in BD group (p<0,0001). IVRT was longer in BD group than in controls, but it did not reach statistical significance (p=0,06). Diastolic dysfunction of LV is more frequent in patients with BD than in control according to E/A and As'. Conventional and current techniques like TDI and colour M-mode Doppler echocardiography could be used to investigate diastolic functions in BD.

Assessment of Left Ventricular Diastolic Function in Egyptian Patients With Behçet’s Disease

“…Unlike our findings, patients with BD had longer E wave DT and IVRT as compared to the controls. Baris et al, 23 found a similar impairment of the LVDD in patients with BD. Assessment was made using several echocardiographic parameters including the transmitral flow velocities, TDI, and M-mode flow propagation velocity.…”

“…The other diastolic parameters were within normal range. 23 In a previous study, Heper et al 12 studied the cardiac changes in 30 patients with BD using the conventional Doppler, electrocardiographic recordings, and transesophageal echocardiography. Patients with BD had longer E wave DT and IVRT compared to the controls.…”

Evaluation of Ventricular Diastolic Function in Patients With Fibromyalgia Syndrome

“…In the literature, diastolic dysfunction has been studied in some other rheumatic diseases such as rheumatoid arthritis, scleroderma, ankylosing spondylitis, and Behçet's disease. [14][15][16][17][18] These studies focused on inflammatory mechanisms, vasculitic and fibrotic changes of the heart which are the causes of distensibility, abnormal diastolic filling, impaired relaxation, and diastolic stiffness of the left ventricle. However, FM is a non-inflammatory disorder different from the aforementioned rheumatic diseases.…”

Cardiovascular Involvement in Behçet's Disease

“…[4][5][6][7][8] To date, there have been several studies investigating the cardiac functions in BD. [9][10][11][12][13][14] In those studies, conventional echocardiography has been used for the assessment of cardiac function. However, several controversial results were obtained particularly regarding diastolic functions.…”

“…However, several controversial results were obtained particularly regarding diastolic functions. [9][10][11][12][13][14] Hence, novel methods for more objective estimation of the cardiac functions such as tissue Doppler echocardiography (TDE) or Doppler-derived myocardial performance index (MPI) might be helpful in BD. Such as, MPI, which combines both systolic and diastolic function, 15 ventricular dyssynchrony, which indicates heterogeneity of contraction time between different myocardial segments, may give a better reflection of the global left ventricular (LV) function than conventional echocardiography, though, to our knowledge, these have not been investigated so far.…”