Behçet Hastalarında Kardiyak Tutulum: Retrospektif Tek Merkez Deneyimi

Year 2024, Volume: 46 Issue: 2, 262 - 268, 18.03.2024

Mustafa Dinler Nazife Şule Yaşar Bilge Reşit Yıldırım Muzaffer Bilgin Timuçin Kaşifoğlu

https://doi.org/10.20515/otd.1375694

Abstract

Behçet hastalığının (BH) mukokutanöz tutulumu iyi bilinmektedir, ancak kardiyak tutulum nadirdir ve artmış morbidite ve mortalite ile ilişkilidir. Bu çalışmada, BH’nin kardiyak tutulumunun klinik özelliklerini ortaya koymayı amaçladık. 2000-2021 yılları arasında 800 BH tanılı hastayı kardiyak tutulum açısından retrospektif olarak taradık. Bu kriterleri karşılayan 14 hasta çalışmaya dahil edildi. Demografik bilgiler, klinik özellikler, tedavi yöntemleri ve prognoz değerlendirildi. Hastaların tamamı erkek ve sigara içiyordu. Kardiyak tutulum için ortalama yaş 32,5±7,8 yıl olarak saptandı. Hastaların üçte birinde hastalık tanısı konmadan önce kardiyak tutulum gelişmişti. Hastalar üç ana gruba ayrıldı: 8’i intrakardiyak tromboz (İKT), 2’si koroner arter anevrizması ve 4’ü miyokard infarktüsü (Mİ). İKT’nin çoğunluğu sağ ventrikülde idi (6/8). Mİ olgularının tümünde sol ana koroner arter tamamen tıkanmıştı. Hastaların %57’sinde derin ven trombozu vardı. Steroidler en sık tercih edilen ajandı. 9 hastada Siklofosfamid 4 hastada azatioprin ve interferon kullanılmıştı. 10 hastaya varfarin ve 4’üne antitrombotik ilaç verildiği görüldü. Mortalite izlenen iki olguda ölüm nedeni bilinmiyordu. Kardiyak tutulum nadir olsa da BH’nin ciddi bir tutulum tipidir. Çoğunlukla sağ kalp boşluklarında İKT ile karşımıza çıktığı gözlendi. Erkek cinsiyet ve sigara kullanımı bu popülasyondaki en önemli risk faktörü olarak bulunmuştur.

Keywords

Behçet hastalığı, kardiyak tutulum, intrakardiyak tromboz, koroner arter anevrizması, miyokardiyal infarktüs.

Cardiac Involvement In Patients With Behcet’s Disease: A Retrospective, Single-Center Experience

Abstract

Behcet’s disease (BD) is well-known with mucocutaneous involvement, whereas the heart may rarely be involved, predicting morbidity and mortality. In this study, we aimed to reveal the clinical characteristics of cardiac involvement in BD. We retrospectively screened 800 BD patients diagnosed between 2000 and 2021 for cardiac involvement. 14 patients who met these criteria were recruited in this study. Demographic information, clinical features, treatment modalities, and prognosis were evaluated. All patients were male and smokers. The mean age for cardiac involvement was estimated at 32.5 ±7,8 years. Cardiac involvement developed in one-third of the patients before disease diagnosis. Patients were classified into three major groups: 8 of intracardiac thrombosis (ICT), 2 of coronary artery aneurysms, and 4 of myocardial infarction (MI). The majority of ICT was seen in the right ventricle (6 out of 8). In all MI cases, the left main coronary artery was totally occluded. Deep vein thrombosis was seen in 57% of patients. Apart from steroids, cyclophosphamide was the most common preferred agent, used in 9 patients. Azathioprine and interferon use were seen in 4 cases. Warfarin was used in 10 patients and 4 cases received an antithrombotic agent. Mortality was seen in 2 cases due to unknown causes. Cardiac involvement is rare, but a serious manifestation of BD. ICT was the most common type with mostly involved the right heart chambers. Male gender and smoking were found as the most important associated risk factors in this population.

Keywords

Behcet’s disease, cardiac involvement, intracardiac thrombosis, coronary artery aneurysm, myocardial infarction

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