Evaluation of pulmonary artery stiffness patients with Behcet's disease

Year 2019, , 22 - 26, 31.03.2019

Hayriye Şahinli , Mustafa Gökhan Vural , Göksal Keskin

https://doi.org/10.21601/ortadogutipdergisi.433615

Abstract

Aim: Behçet's disease is a systemic
vasculitis affecting arteries and veins in every dimension. Aortic and pulmonary
artery aneurysms are the most important causes of mortality in Behçet's
disease. In the histopathology of the aneurysm, full-thickness irregular
fibrous thickening plays a role in the vessel wall. Cardiovascular mortality
and morbidity were found to increase with increasing stiffness in the large
vessels.

We aimed to
evaluate the pulmonary artery elasticity in patients with BD with
Echocardiography  (ECO) which is one of
the non-invasive methods.

Material and Methods: Twenty seven (18
female, 9 male)  Behcet’ patients and
twenty one healthy controls (9 female, 12 male)  are included to the study. Pulmonary artery is
evaluated with ECO. Pulmonary strain, beta index, distensibility are used as
pulmonary elasticity parameters.

Results: Twenty seven Behcet’ patients
and twenty one healthy controls are included to the study. Pulmonary artery
strain and pulmonary artery distensibility values of the Behcet’s group were
observed to be significantly lower than the control group (p<0,001,
p<0,001); where as pulmonary artery beta index was significantly higher (
p=0,022).

Conclusion: Pulmonary stiffness is
significantly increased in patients with Behcet’s disease compaired to healty
control group.for identification of pulmonary artery aneurizm in an early echocardiographic
examination of pulmoner artery stiffness can be used.

Keywords

Behcet's disease, pulmonary artery aneurysm, pulmoner artery stiffness

Behçet hastalarında pulmoner arter sertliğinin değerlendirilmesi

Abstract

Amaç: Behçet hastalığı her
boyda arter ve venleri etkileyen sistemik bir vaskülittir.  Behçet hastalığında, aort ve pulmoner
arter  anevrizması en önemli mortalite
nedenlerindendir. Anevrizmanın histopatolojisinde, damar duvarında tam kat
düzensiz fibröz kalınlaşma rol oynamaktadır. Büyük damarlardaki sertliğin
artmasıyla kardiovasküler mortalite ve morbiditenin arttığı bulunmuştur. Behçet hastalarında pulmoner arter
elastisite özelliklerini invaziv olmayan yöntemlerden biri olan  ekokardiografi (EKO)  ile değerlendirmeyi amaçladık.

Gereç ve Yöntemler: Çalışmaya
27  Behçet hastası (18 kadın, 9 erkek) ve
21 sağlıklı kontrol  grubu ( 9 kadın, 12
erkek)  alındı. Pulmoner arter,  ekokardiografi 
ile değerlendirildi. Pulmoner elastisite parametreleri olarak pulmoner
strain, beta indeksi ve distensibilite alındı.

Bulgular: Çalışmaya 27 Behçet
olgusu ile 21 sağlıklı kontrol grubu alındı. Kontrol grubuna göre,  Behçet hastalığı grubunda pulmoner arter
strain ve pulmoner arter distensibilite değeri anlamlı olarak daha düşük
bulundu (p<0,001, p<0,001). Pulmoner arter beta indeksi ise anlamlı
olarak daha yüksek bulundu (p=0,022) .

Sonuç: Behçetli hasta grubunda
pulmoner sertliğin, sağlıklı kontrol grubuna göre anlamlı olarak arttığı
sonucuna varılmıştır.  Erken dönemde, pulmoner
arter anevrizmasının  tesbitinde,  pulmoner arter sertliğinin  ekokardiografi ile değerlendirilmesi
kullanılabilir bir yöntemdir.

Keywords

Behçet hastalığı, pulmoner arter anevrizması, pulmoner arter sertliği

References

• 1. Direskeneli H. Behçet’s disease: infectious aetiology, new autoantigens, and HLA-B51. Ann Rheum Dis 2001;60: 996-1002
• 2. Alpsoy E. Behçet hastalığının deri ve mukoza belirtileri. Türkderm 2003; 37: 92-99
• 3. Saylan T. Live story of Dr. Hulusi Behçet. Yonsei Med J 1997; 38: 327-32
• 4. Li JK. The arterial circulation: physical principles and clinical applications. Totowa NJ, Humana Press:2000
• 5. Eidem BW, Tei C, O’Leary PW, Cetta F, Seward JB, Nongeometric quantitative assessment of right and left ventricüler function performance index in normal children and patients with Ebstein anomaly. J Am Soc Echocardiogr 1998;11: 849-51
• 6. Rougin A, Edute Y, Milo S. Et al. A fatal case of Behçet’s disease associated with multiple cardiovascular lesions. Int J Cardiol 1997; 59: 267-73
• 7. Stefanadis C, Stratos C, Boudoulas H, et.al. Distensibility of ascending aorta comparison of invasive and noninvasive tecniques in healty men and womens with coronary artery disease. Eur heart j 1990; 11: 990-96
• 8. Fukuda Y, Watanabe I, Hayashi H ve ark. Pathological studies on Behçet’s disease. Ryumachi. 1980; 20: 268-75
• 9. Matsumoto T, Uekusa T, Fukuda Y. Vasculo-Behcet’s disease: a pathologic study of eight cases. Hum pathol 1991; 22 :45-51
• 10. Musabak U, Pay S, Erdem H, et al. Correlation of serum IL-18 levels with disease activity and clinical presentation in patients with Behçet’s disease. Clin Exp Rheumatol 2004; 22: 97
• 11. Frassanito MA, Dammacco R, Cafforio P, Dammacco F. Th1 polarization of the immune response in Behcet's disease: a putativepathogenetic role of interleukin-12. Arthritis Rheum 1999; 42: 1967-74.
• 12. Sugi-Ikai N, Nakazawa M, Nakamura S, Ohno S, Minami M. Increased frequencies of interleukin-2- and interferon-gamma-producing T cells in patients with active Behcet's disease. Invest Ophthalmol Vis Sci 1998; 39: 996-1004.
• 13. Tunç S.E, Doğan A, Gedikli Ö, Arslan Ç, Şahin M. Assessment of aortic stiffness and ventricular diastolic functions in patients with Behçet disease. Rheumatol Int 2005; 25: 447-51
• 14. Duman D, Masatlıoğlu S, Demirtunç R, Karadağ B. Increased pulmoner artery stiffness and its relation to right ventricular function in patients with systemic lupus erythematosus. Turk Kardiyol Dern Ars 2008; 36: 82-89
• 15. Yavuz B, Şahiner L, Akdoğan A, et al. Left and right ventriküler function is impaired in Behçet’s Disease. Echocardiography 2006; 23: 723-28