Morphologic evidence of subclinical atherosclerosis obtained by carotid ultrasonography in patients with Behcet’s disease

Abstract

Subclinical atherosclerosis can be demonstrated by measuring the intima-media thickness (IMT) of the carotid arteries by high-resolution B-mode ultrasonography (US). Endothelial injury appears a key event in the atherogenesis. Endothelial cell activation and/or injury are the characteristic features of Behçet's disease (BD). In this study, we investigated morphologic evidence of subclinical atherosclerosis in the BD patients by using high-resolution B-mode US. Thirty-four patients with BD without arterial involvement (male/female 21/13; mean age 34.6+/-8.5 years) were individually matched to control subjects on the basis of age (within 2 years) and sex. Subjects with diabetes mellitus, hypertension, evidence of myocardial infarction or cerebrovascular disease, and patients on long-term steroids (i.e., >6 months) were excluded from the study. Mean IMT values of the right carotid arteries were 0.81+/-0.17 mm for patients with BD, and 0.54+/-0.13 mm for healthy controls (P<0.001). Mean IMT values of the left carotid arteries were 0.82+/-0.16 mm for patients with BD, and 0.55+/-0.12 mm for healthy controls (P<0.001). The overall prevalence of carotid atherosclerotic plaques was higher among the patients than the controls [prevalence of plaques were 17.6% (6/34) in BD patients and 0% in healthy controls, P<0.05]. In conclusion, our data indicate morphologic evidence of subclinical atherosclerosis in patients with BD.

Subclinical Atherosclerosis in Behçet’s Disease

“…[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. The development of atherosclerosis has an inflammatory component; however, it is not clear whether hepatitis B and C viral infections are associated with the risk of atherosclerosis.…”

Predictors of Coronary Artery Disease in Patients with Behçet's Disease

“…An increased degree of endothelial cell injury and pathological activation has been reported in BD, with studies showing elevated levels of endothelial injury markers like soluble thrombomodulin, von Willebrand factor, and circulating E-selectins associated with this disease [12]. Recent studies have also shown a higher prevalence of carotid atherosclerotic plaques and increased carotid intimal thickening in patients with BD, further suggesting that these patients have an increased burden of subclinical atherosclerosis [13]. This is mediated by increased oxidative stress-related endothelial dysfunction in these subjects [14].…”

An Assessment of Flow-Mediated Dilatation in Behçet’s Disease

“…[8][9][10][21][22][23][24][25][26] Increased values of IMT with BD have been reported in some studies. [7][8][9] Alan et al [8] also proved the existence of decreased arterial distensibility in BD, and Rhee et al [22] detected increased arterial stiffness in BD. Akçar et al [26] reported lower peak systolic and end-diastolic flow velocities throughout internal carotid artery.…”

“…[11] Many authors have proven that inflammation is also an independent risk factor for this disease. [3][4][5][6][7][17][18][19] Indeed, ECD can be demonstrated in more than one vascular bed, and this is related to focal inflammation. Suppression of the immune inflammatory process may result in the reversal of ECD.…”

“…[3][4][5][6] Atherosclerosis is widely accepted as a low-grade chronic inflammatory disorder, [3,7] and previous studies have reported a predisposition to its development in BD. [8][9][10] By the time clinical findings of atherosclerosis appear, the disease is at an advanced stage, and treatment is palliative.…”