Patients with Behcet's disease carry a higher risk for microvascular involvement in active disease period.
BACKGROUND
Behcet's disease (BD) is characterized with remissions and exacerbations. However, to date, there is no study to investigate a possible association of disease activity (active versus inactive disease period) with cardiovascular complications.


METHODS
Forty patients with BD were evaluated in both active and in inactive disease period. For the control group 45 healthy volunteers, age and sex matched, were registered. Subjects with at least a 15-day lesion-free period were regarded in inactive disease period, and subjects with any oral, skin, and/or genital lesion was regarded as in active disease period. In each subject coronary diastolic peak flow velocities (DPFV) were measured at baseline and after dipyridamole infusion (0.84 mg/kg over 6 minutes) using an Acuson Sequoia C256 echocardiography system. Coronary flow reserve (CFR) was defined as the ratio of hyperemic to baseline DPFV.


RESULTS
CFR values were significantly lower in BD patients compared to the controls (2.57+/-0.50 versus 2.87+/-0.53, P = 0.006). In active disease period, basal DPFV (24.6+/-7.5 versus 27.3+/-6.6, P = 0.019) was significantly higher than in the inactive disease period. In the active disease period hyperemic DPFV (61.7+/-14.9 versus 56.8+/-16.7, P = 0.015) values decreased significantly. Therefore, in the active disease period CFR significantly decreased from 2.57+/-0.50 to 2.09+/-0.46, P<0.001. The only independent predictor of CFR within the active disease period was the disease duration (beta = -0.384, P = 0.012).


CONCLUSIONS
Within the active disease period, coronary microvascular function is more prominently impaired in BD patients. Therefore, BD patients are possibly more vulnerable to cardiovascular manifestations when they are in an active disease period.
Gullu
Hakan
H
Baskent University, Faculty of Medicine, Department of Cardiology, Ankara, Turkey. gulluhakan@hotmail.com
Caliskan
Mustafa
M
Erdogan
Dogan
D
Yilmaz
Sema
S
Dursun
Recep
R
Ciftci
Ozgur
O
Topcu
Semra
S
Yucel
Eftal
E
Muderrisoglu
Haldun
H
D000328:Adult; D000367:Age Factors; D001528:Behcet Syndrome / Q000503:physiopathology*; D001783:Blood Flow Velocity / Q000502:physiology; D016022:Case-Control Studies; D008076:Cholesterol, HDL / Q000097:blood; D003326:Coronary Circulation / Q000502:physiology*; D003971:Diastole / Q000502:physiology; D004452:Echocardiography; D005260:Female; D006801:Humans; D008297:Male; D013997:Time Factors
D008076:Cholesterol, HDL