Evaluation of right ventricular function in patients with Behcet's disease by four-dimensional echocardiography.
Humans
Behcet Syndrome
/ physiopathology
Male
Female
Adult
Ventricular Dysfunction, Right
/ physiopathology
Heart Ventricles
/ diagnostic imaging
Reproducibility of Results
Echocardiography
/ methods
Pulmonary Artery
/ physiopathology
Ventricular Function, Right
/ physiology
Middle Aged
Vascular Stiffness
/ physiology
Behcet disease
pulmonary arterial stiffness
pulmonary pulse transit time
right ventricle
Journal
Echocardiography (Mount Kisco, N.Y.)
ISSN: 1540-8175
Titre abrégé: Echocardiography
Pays: United States
ID NLM: 8511187
Informations de publication
Date de publication:
Sep 2024
Sep 2024
Historique:
revised:
08
08
2024
received:
22
06
2024
accepted:
21
08
2024
medline:
31
8
2024
pubmed:
31
8
2024
entrez:
31
8
2024
Statut:
ppublish
Résumé
Behcet's disease (BD) is a systemic disorder characterized by vasculitis, resulting in thickened vascular walls that reduce elasticity and impair function. BD can involve the cardiovascular system in three ways: cardiac, arterial, and venous. In this study, our objective was to evaluate the efficacy of pulmonary arterial stiffness (PAS) and pulmonary pulse transit time (PPTT) measures in demonstrating right ventricular functions in asymptomatic BD patients. We aimed to objectively evaluate right ventricular function in patients with BD using four-dimensional echocardiography (4DE). This study included 40 patients diagnosed with BD and 40 healthy subjects. Demographic, clinical, laboratory, and echocardiographic parameters were compared. In addition to standard transthoracic echocardiographic evaluation, right ventricle quantification (RVQ) by using the 4DE and 2D-speckle tracking echocardiography were performed. The sPAP, 4D RVQ, and right ventricular strain values exhibited significant differences between the BD and control groups. Right ventricular end-diastolic diameter (RVDD), right ventricular end-systolic diameter (RVSD), right atrium (RA) area, right ventricular myocardial performance index (RVMPI), and PAS were increased in BD patients compared to the control group. Right ventricular ejection fraction (RVEF), right ventricular fractional area change (RVFAC), tricuspid annular plane systolic excursion (TAPSE), Tricuspid S', and PPTT were decreased in BD patients compared to control subjects. PPTT correlated with right ventricular free wall strain (RV-FWS) and PAS. In a multivariate linear regression analysis, PAS and RVFAC were found to be independent predictors of RVFWS. In addition, RVFAC and TAPSE are independent predictors for PPTT. Patients with BD may have elevated pulmonary arterial stiffness (PAS) in correlation with decreased PPTT. To ascertain the prognosis for these individuals, right ventricular (RV) functions must be evaluated. Measurements of RVFAC and RVEF via 4DE and deformation imaging techniques may be more useful in identifying subclinical impairment of RV. Individuals with BD, PAS, and PPTT may suggest a link between early pulmonary vascular remodeling and RV subclinical impairment.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e15918Informations de copyright
© 2024 Wiley Periodicals LLC.
Références
Sezen Y, Buyukhatipoglu H, Kucukdurmaz Z, et al. Cardiovascular involvement in Behçet's disease. Clin Rheumatol. 2010;29:7‐12.
Deng Z, Wang X, Li T, et al. Clinical characteristics and predictors for cardiovascular system involvement in patients with Behçet's disease. Clin Exp Rheumatol. 2023;41:1964‐1969.
Wang L, Jiang R, Zhao QH, et al. Clinical analysis of Behçet disease associated with pulmonary vascular disease. Zhonghua Jie He He Hu Xi Za Zhi. 2017;40:343‐348.
Kural‐Seyahi E, Fresko I, Seyahi N, et al. The long‐term mortality and morbidity of Behcet Syndrome: a 2‐Decade outcome survey of 387 patients followed at a dedicated center. Medicine (Baltimore). 2003;82:60‐76.
Yagmur J, Sener S, Acikgoz N, et al. Subclinical left ventricular dysfunction in Behcet's disease assessed by two‐dimensional speckle tracking echocardiography. Eur J Echocardiogr. 2011;12:536‐541.
Yurdakul S, Erdemir VA, Tayyareci Y, et al. Subclinical left and right ventricular systolic dysfunction in Behcet's disease: a combined tissue doppler and velocity vector imaging study. J Clin Ultrasound. 2013;41:347‐353.
Yenerçağ M, Arslan U, Dereli S, et al. Effects of angiotensin receptor neprilysin inhibition on pulmonary arterial stiffness in heart failure with reduced ejection fraction. Int J Cardiovasc Imaging. 2021;37:165‐173.
Görgülü S, Eren M, Yildirim A, et al. A new echocardiographic approach in assessing pulmonary vascular bed in patients with congenital heart disease: pulmonary artery stiffness. Anadolu Kardiyol Derg. 2003;3:92‐97.
Wibmer T, Rüdiger S, Scharnbeck D, et al. Pulmonary pulse transit time: a novel echocardiographic indicator of hemodynamic and vascular alterations in pulmonary hypertension and pulmonary fibrosis. Echocardiography. 2015;32:904‐911.
Lang RM, Badano LP, Mor‐Avi V, et al. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr. 2015;28:1‐39.
Badano LP, Kolias TJ, Muraru D, et al. Standardization of left atrial, right ventricular, and right atrial deformation imaging using two‐dimensional speckle tracking echocardiography: a consensus document of the EACVI/ASE/Industry Task Force to standardize deformation imaging. Eur Heart J Cardiovasc Imaging. 2018;19:591‐600.
Saadoun D, Bodaghi B, Cacoub P. Behçet's Syndrome. N Engl J Med. 2024;390:640‐651.
Alpsoy E. Behçet's disease: treatment of mucocutaneous lesions. Clin Exp Rheumatol. 2005;23:532‐539.
Tascilar K, Melikoglu M, Ugurlu S, et al. Vascular involvement in Behcet's syndrome: a retrospective analysis of associations and the time course. Rheumatology (Oxford). 2014;53:2018‐2022.
Saadoun D, Vautier M, Cacoub P. Medium‐ and large‐vessel vasculitis. Circulation. 2021;143:267‐282.
Kutluğ Ağaçkıran S, Sünbül M, Doğan Z, et al. Pulmonary arterial wall thickness increased in Behçet's disease patients with major organ involvement: is it a sign of severity? Rheumatology (Oxford). 2023;62:1238‐1242.
Seyahi E, Yazici H. Behçet's syndrome: pulmonary vascular disease. Curr Opin Rheumatol. 2015;27:18‐23.
Yildizeli SO, Yanartaş M, Tas S, et al. Outcomes of patients with Behçet's syndrome after pulmonary endarterectomy. Thorac Cardiovasc Surg. 2018;66:187‐192.
del Coromoto Leon Suárez P, de Larrinoa1 IRFF, Urso S, Esmenota JDM. Reversible pulmonary hypertension with operation of large intramediastinal pseudoaneurysm and anti‐inflammatory treatment in patients with Behcet disease. BMJ Case Rep. 2021;14(9):245332.
Mahdavi M, Asadian S, Rezaeian N, et al. Chronic thromboembolic pulmonary hypertension secondary to Behçet's disease: an extremely rare pediatric case. Cardiol Young. 2022;32:315‐319.
Armağan B, Okşul M, Şener YZ, et al. Pulmonary hypertension in Behçet's disease: echocardiographic screening and multidisciplinary approach. Turk J Med Sci. 2023;53:563‐571.
Çamcı S, Yılmaz E. Effects of sodium‐glucose co‐transporter‐2 inhibition on pulmonary arterial stiffness and right ventricular function in heart failure with reduced ejection fraction. Medicina (Kaunas). 2022;58:1128.
Çoksevim M, Çerik İB, Yenerçağ M, et al. Assessment of pulmonary arterial stiffness in patients with systemic sclerosis without overt pulmonary hypertension. Int J Cardiovasc Imaging. 2022;38:2191‐2197.
Prins KW, Weir EK, Archer SL, et al. Pulmonary pulse wave transit time is associated with right ventricular‐pulmonary artery coupling in pulmonary arterial hypertension. Pulm Circ. 2016;6:576‐585.
Fourie PR, Coetzee AR, Bolliger CT. Pulmonary artery compliance: its role in right ventricular‐arterial coupling. Cardiovasc Res. 1992;26:839‐844.
Yavuz B, Sahiner L, Akdogan A, et al. Left and right ventricular function is impaired in Behçet's disease. Echocardiography. 2006;23:723‐728.
Cobankara V, Guclu A, Kuru O, et al. Evaluation of biventricular myocardial performance index in patients with Behçet's disease. J Int Med Res. 2012;40:328‐332.
Dinc Asarcikli L, Saritas F, Guvenc TS, et al. Alterations in right ventricular mechanics in patients with Behcet's disease. Int J Cardiovasc Imaging. 2022;38:2333‐2343.
Hahn RT, Lerakis S, Delgado V, et al. Multimodality imaging of right heart function: JACC scientific statement. J Am Coll Cardiol. 2023;81:1954‐1973.