Department of Cardiology, Marmara University School of Medicine, Istanbul, Turkey.
Department of Neurology, Marmara University School of Medicine, Istanbul, Turkey.
Acta Cardiol. 2022 Aug;77(6):515-523. doi: 10.1080/00015385.2021.1965354. Epub 2021 Aug 16.
Behcet's disease (BD) may present with life threating complications including neurological and cardiovascular involvement. Neuro-Behcet's disease (NBD) is one of the most important causes of morbidity and mortality in patients with BD. The aim of the present study is to investigate whether patients with NBD are different than BD patients with other manifestations in terms of subclinical myocardial dysfunction.
Forty patients with NBD (23 female, mean age: 42.4 ± 9.4 years), 40 patients with BD (9 female, mean age: 39.7 ± 9.0 years) and 40 controls (20 male, mean age: 41.8 ± 6.5 years) were consecutively included in the study. All subjects underwent a transthoracic echocardiography for evaluation of left ventricular (LV) and atrial (LA) functions with two-dimensional (2D) speckle tracking echocardiography (STE).
Baseline characteristics, clinical data, LV dimensions, systolic and diastolic functions were all in normal range among the groups. LV global longitudinal strain (LV-GLS) was significantly lower in patients with NBD and BD patients without neurologic involvement compared to controls. LA conduit strain was significantly lower in patients with NBD compared to controls. Patients with both parenchymal NBD and vascular NBD manifestations had significantly lower LV-GLS and LA conduit strain compared to controls. Linear regression analysis demonstrated that among cardiovascular risk factors only presence of NBD was the independent predictor of LV-GLS.
BD is associated with impaired LV and LA functions. LV-GLS and LA conduit strains of the patients with NBD were lower. NBD was an independent predictor of LV-GLS, suggesting a link between neurological manifestations and cardiac dysfunction in BD patients.
白塞病(BD)可能会出现危及生命的并发症,包括神经系统和心血管系统受累。神经白塞病(NBD)是 BD 患者发病率和死亡率的最重要原因之一。本研究旨在探讨 NBD 患者与其他表现形式的 BD 患者在亚临床心肌功能障碍方面是否存在差异。
连续纳入 40 例 NBD 患者(23 例女性,平均年龄:42.4±9.4 岁)、40 例无神经系统受累的 BD 患者(9 例女性,平均年龄:39.7±9.0 岁)和 40 例对照组(20 例男性,平均年龄:41.8±6.5 岁)。所有受试者均接受经胸超声心动图检查,采用二维斑点追踪超声心动图(STE)评估左心室(LV)和心房(LA)功能。
三组间的基本特征、临床资料、LV 大小、收缩和舒张功能均在正常范围内。与对照组相比,NBD 患者和无神经系统受累的 BD 患者的 LV 整体纵向应变(LV-GLS)明显降低。与对照组相比,NBD 患者的 LA 传导管应变明显降低。同时存在实质 NBD 和血管 NBD 表现的患者的 LV-GLS 和 LA 传导管应变明显低于对照组。线性回归分析表明,在心血管危险因素中,只有 NBD 的存在是 LV-GLS 的独立预测因子。
BD 与 LV 和 LA 功能障碍有关。NBD 患者的 LV-GLS 和 LA 传导管应变较低。NBD 是 LV-GLS 的独立预测因子,提示 BD 患者的神经表现与心脏功能障碍之间存在关联。