Gemici K, Baran I, Güllülü S, Kazazoglu A R, Cordan J, Ozer Z
Department of Cardiology, University of Uludag, School of Medicine, Görükle 16059, Bursa, Turkey.
Int J Cardiol. 2000 Apr 28;73(2):143-8. doi: 10.1016/s0167-5273(00)00175-3.
Behcet's disease is a generalized chronic inflammatory disease characterized by genital, ocular, and cardiovascular involvement. Recently, left ventricular diastolic dysfunction, ventricular arrhythmia and sudden cardiac death have been documented in Behcet's disease. From January 1996 to May 1998, we investigated left ventricular systolic and diastolic function, valvular heart disease, ischemic heart disease and repolarization dispersion in 71 cases, 40 men and 31 women (mean age, 36.8+/-10.3 years) with Behcet's disease. All of the results were compared with the control group of 33 men and 22 women (mean age, 37.9+/-9.6 years). Exercise stress test or myocardial perfusion scintigraphy was performed for the documentation of ischemia. All the patients and the controls were recorded by M-mode, 2-D and Doppler echocardiography. Ventricular wall thickness, valvular apparatus, left ventricular systolic and diastolic parameters were evaluated. Repolarization dispersion parameters were calculated as the difference between maximal and minimal values of QT from 12-lead electrocardiogram recording at baseline, immediate and end of recovery from the exercise stress tests. The measured parameters were compared with the control group by using statistical methods. In the Behcet's group of 22 patients (31%) E/A ratio was <1. In the control group of five cases (10%) E/A ratio was <1 (P=0.003). In the Behcet's group isovolumic relaxation time (IRT) and mitral deceleration time (MDT) were longer than the control group (P=0.002, P=0.041, respectively). A mean QT of 368+/-30 ms and mean QT dispersion of 73+/-14 ms in the patient group compared with a mean QT of 395+/-39 ms and mean QT dispersion of 38+/-12 ms in the controls. There was no statistical difference between the mean QT values of the patient and control groups however, ventricular dispersion parameters in the Behcet's patients were longer than in the controls (P<0.001). There was also statistical significance for the QT dispersion between the Behcet's patients with and without diastolic dysfunction (P<0.01). In conclusion, the study reveals that the patients with Behcet's disease have a high incidence of increased diastolic dysfunction and repolarization dispersion. A positive correlation may exist between diastolic dysfunction and QT dispersion.
白塞病是一种全身性慢性炎症性疾病，其特征为累及生殖器、眼部和心血管系统。最近，已有文献记载白塞病患者存在左心室舒张功能障碍、室性心律失常和心源性猝死。1996年1月至1998年5月，我们对71例白塞病患者（40例男性，31例女性，平均年龄36.8±10.3岁）的左心室收缩和舒张功能、心脏瓣膜病、缺血性心脏病和复极离散度进行了研究。所有结果均与由33例男性和22例女性（平均年龄37.9±9.6岁）组成的对照组进行比较。通过运动负荷试验或心肌灌注显像来记录是否存在心肌缺血。所有患者和对照组均接受M型、二维和多普勒超声心动图检查。评估心室壁厚度、心脏瓣膜结构、左心室收缩和舒张参数。复极离散度参数通过计算运动负荷试验基线、即刻及恢复末期12导联心电图记录中QT的最大值与最小值之差得出。采用统计学方法将测量参数与对照组进行比较。在白塞病组的22例患者（31%）中，E/A比值<1。在对照组的5例患者（10%）中，E/A比值<1（P=0.003）。白塞病组的等容舒张时间（IRT）和二尖瓣减速时间（MDT）均长于对照组（分别为P=0.002，P=0.041）。患者组的平均QT为368±30 ms，平均QT离散度为73±14 ms，而对照组的平均QT为395±39 ms，平均QT离散度为38±12 ms。患者组和对照组的平均QT值之间无统计学差异，然而，白塞病患者的心室离散度参数长于对照组（P<0.001）。有舒张功能障碍和无舒张功能障碍的白塞病患者之间的QT离散度也具有统计学意义（P<0.01）。总之，该研究表明白塞病患者舒张功能障碍和复极离散度增加的发生率较高。舒张功能障碍与QT离散度之间可能存在正相关。
