Sun Byung Joo, Park Jae-Hyeong, Yoo Su-Jin, Park Yunseon, Kim Yeon Ju, Lee In Suk, Kim Jinhyun, Yoo In Seol, Shim Seung Cheol, Kang Seong Wook, Kim Jun-Hyung, Lee Jae-Hwan, Choi Si Wan, Jeong Jin-Ok, Seong In-Whan
Division of Cardiology, Department of Internal Medicine, School of Medicine, Chungnam National University, Chungnam National University Hospital, Daejeon, Korea.
Division of Rheumatology, Department of Internal Medicine, School of Medicine, Chungnam National University, Chungnam National University Hospital, Daejeon, Korea.
Echocardiography. 2018 Jun;35(6):809-816. doi: 10.1111/echo.13844. Epub 2018 Feb 16.
Although cardiac manifestation of Behçet disease (BD) has been described in sporadic reports, its timely diagnosis remains difficult. The objective of this study was to describe early cardiac manifestations of BD. We also performed a comprehensive classification of systemic BD activity and compared their cardiac manifestations.
A prospective screening using speckle tracking echocardiography was performed in 85 patients with BD who had no history of heart disease. After excluding subjects with left ventricular (LV) ejection fraction (LVEF) <50% (n = 1), atrial fibrillation (n = 2), or inadequate echocardiographic images (n = 1), we analyzed their clinical and echocardiographic parameters including LV global longitudinal strains (GLS) and compared them with those of an age- and gender-matched control group (n = 145). Systemic BD activity was classified as minimal (Group A), controlled (Group B), and active (Group C).
In 81 study patients (59 females, age of 51 ± 11 years), echocardiography revealed a mean LVEF of 64 ± 5% without any significant valvular dysfunction or aortic aneurysm. Although there was no difference in LVEF between the control group and the patient group, the patient group showed significant reduction in GLS (-17.1 ± 2.9% vs -20.8 ± 2.2%, P < .001). Groups A (n = 21, 26%), B (n = 47, 58%), and C (n = 13, 58%) consistently showed reduction in GLS compared with the control group. However, there was no significant difference in cardiac manifestations among these groups according to systemic disease activity.
Patients with BD present intrinsic LV dysfunction despite no apparent abnormality on routine echocardiography. However, their cardiac manifestations are not proportional to systemic BD activity.
尽管白塞病（BD）的心脏表现已有零星报道，但其及时诊断仍很困难。本研究的目的是描述BD的早期心脏表现。我们还对系统性BD活动进行了全面分类，并比较了它们的心脏表现。
对85例无心脏病史的BD患者进行了使用斑点追踪超声心动图的前瞻性筛查。在排除左心室（LV）射血分数（LVEF）<50%的受试者（n = 1）、心房颤动患者（n = 2）或超声心动图图像不充分的患者（n = 1）后，我们分析了他们的临床和超声心动图参数，包括LV整体纵向应变（GLS），并将其与年龄和性别匹配的对照组（n = 145）进行比较。系统性BD活动分为轻度（A组）、受控（B组）和活动（C组）。
在81例研究患者（59例女性，年龄51±11岁）中，超声心动图显示平均LVEF为64±5%，无任何明显的瓣膜功能障碍或主动脉瘤。尽管对照组和患者组之间的LVEF没有差异，但患者组的GLS显著降低（-17.1±2.9%对-20.8±2.2%，P <.001）。与对照组相比，A组（n = 21，26%）、B组（n = 47，58%）和C组（n = 13，16%）的GLS持续降低。然而，根据系统性疾病活动情况，这些组之间的心脏表现没有显著差异。
BD患者尽管常规超声心动图无明显异常，但存在内在的LV功能障碍。然而，他们的心脏表现与系统性BD活动不成比例。
