FRI0391 Ankle Brachial Index, Pulse Wave Velocity and Echocardiographic Study in 81 Patients with Behçet's Disease

Abstract

BackgroundBehçet's disease (BD) is a multisystemic vasculitis of unknown etiology. Cardiovascular (CV) involvement has been reported in 1–6% of BD patients. In case of CV involvement, prognosis is poor. The incidence of the CV involvement in Korean patients with BD is not clearly documented.ObjectivesThe aim of this study is to evaluate the CV findings in Korean patients with BD and to prevent or lower mortality and morbidity through early diagnosis and early treatment.MethodsWe performed Ankle Brachial Index (ABI), Pulse wave velocity (PWV) and Echocardiographic screening in 81 patients with BD who fulfilled the International Study Group criteria. PWV was calculated as the brachial-ankle path length divided by the brachial-ankle transit time (baPWV). We compared the result between two groups of patients with BD. Two groups are patients who have been treated with immunosuppressant agent and without immunosuppressant agent. The patients of former group are patients who have been suffered from severe complication or refractory disease.ResultsFifty-nine (72.8%) patients were female. Mean age was 50.6 ± 2.5 years old. Mean age at diagnosis was 40.5 ± 2.3 years old and disease duration was 10.2 ± 1.5 years. Mean ABI was 1.10 ± 0.03. There was no significant difference between with and without immunosuppressant agent treated group. (1.11 ± 0.03 vs. 1.09 ± 0.03, P=0.167). The number of patients with abnormal ABI was 7 (17.5%) vs. 6 (14.6%), P=0.781. Mean PWV (m/sec) was 14.0 ± 0.67. There was no significant difference between two groups (13.8 ± 1.09 vs. 14.2 ± 0.83, P=0.144). But the immunosuppressant treated group had more patients with elevated levels of PWV (>12.0 m/sec) compared to non-immunosuppressant treated group [n =34 (82.9%) vs. n=25 (62.5%), P=0.024]. Echocardiography was done. Left ventricular ejection fraction (%) (64.9 ± 1.5 vs. 63.7 ± 1.7, P=0.254), Left ventricular mass index (g/m2) (74.9 ± 5.0 vs 74.1 ± 5.7, P=0.970), E/E' ratio (8.35 ± 0.9 vs 9.17 ± 1.0, P=0.228), Tricuspid regurgitating velocity (TRV) max (m/sec) (2.35 ± 0.09 vs 2.39 ± 0.11, P=0.572) were similar in both groups. We detected 39 minimal mitral, aortic and tricuspid valve insufficiencies. One patient showed suspiciously resting pulmonary hypertension (TRVmax – 3.3m/sec). In two patients, dilatation of ascending aorta was showed. There was aortic arch mass in one patient.ConclusionsThe CV involvement in BD can be a cause of death. In this screening study, asymptomatic patients showed many CV manifestations. And in 59 (72.8%) patients, PWV was elevated. Arterial stiffness can be a surrogate marker of CV disease. Larger study about CV manifestations in BD must be planned. And during treatment of patients with BD, CV screening study needs to be considered.ReferencesH L Chang, S K Kim, S S Lee, M Y Rhee. Arterial stiffness in Behçet's disease: increased regional pulse wave velocity values. Ann Rheum Dis. 2006 Mar; 65(3): 415–416.Geri G, Wechsler B, Huong DLT, et al. Spectrum of cardiac lesions in Behçet disease: a series of 52 patients and re...