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Liu C, Wu H, Li K, Chi Y, Wu Z, Xing C. Identification of biomarkers for abdominal aortic aneurysm in Behçet's disease via mendelian randomization and integrated bioinformatics analyses. J Cell Mol Med 2024; 28:e18398. [PMID: 38785203 PMCID: PMC11117452 DOI: 10.1111/jcmm.18398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Revised: 04/03/2024] [Accepted: 04/30/2024] [Indexed: 05/25/2024] Open
Abstract
Behçet's disease (BD) is a complex autoimmune disorder impacting several organ systems. Although the involvement of abdominal aortic aneurysm (AAA) in BD is rare, it can be associated with severe consequences. In the present study, we identified diagnostic biomarkers in patients with BD having AAA. Mendelian randomization (MR) analysis was initially used to explore the potential causal association between BD and AAA. The Limma package, WGCNA, PPI and machine learning algorithms were employed to identify potential diagnostic genes. A receiver operating characteristic curve (ROC) for the nomogram was constructed to ascertain the diagnostic value of AAA in patients with BD. Finally, immune cell infiltration analyses and single-sample gene set enrichment analysis (ssGSEA) were conducted. The MR analysis indicated a suggestive association between BD and the risk of AAA (odds ratio [OR]: 1.0384, 95% confidence interval [CI]: 1.0081-1.0696, p = 0.0126). Three hub genes (CD247, CD2 and CCR7) were identified using the integrated bioinformatics analyses, which were subsequently utilised to construct a nomogram (area under the curve [AUC]: 0.982, 95% CI: 0.944-1.000). Finally, the immune cell infiltration assay revealed that dysregulation immune cells were positively correlated with the three hub genes. Our MR analyses revealed a higher susceptibility of patients with BD to AAA. We used a systematic approach to identify three potential hub genes (CD247, CD2 and CCR7) and developed a nomogram to assist in the diagnosis of AAA among patients with BD. In addition, immune cell infiltration analysis indicated the dysregulation in immune cell proportions.
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Affiliation(s)
- Chunjiang Liu
- Department of General SurgeryThe Second Affiliated Hospital of Soochow UniversitySuzhouChina
| | - Huadong Wu
- Department of vascular surgeryFirst affiliated Hospital of Huzhou UniversityHuzhouChina
| | - Kuan Li
- Department of General SurgeryKunshan Hospital of Traditional Chinese MedicineKunshanChina
| | - Yongxing Chi
- Department of General SurgeryThe Second Affiliated Hospital of Soochow UniversitySuzhouChina
| | - Zhaoying Wu
- Department of General SurgeryThe Second Affiliated Hospital of Soochow UniversitySuzhouChina
| | - Chungen Xing
- Department of General SurgeryThe Second Affiliated Hospital of Soochow UniversitySuzhouChina
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Yaşar E. Coronary Involvement of Behçet's Disease: Saccular Coronary Artery Aneurysm. KARDIOLOGIIA 2023; 63:95-96. [PMID: 37970862 DOI: 10.18087/cardio.2023.10.n1931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Accepted: 12/24/2021] [Indexed: 11/19/2023]
Abstract
Coronary artery aneurysms (CAAs) are rarely reported in large angiographic series. The majority are atherosclerotic in origin. Other causes are connective tissue disorders, trauma, vasculitis, congenital, mycotic, and idiopathic. We herein present the case of an symptomatic patient with a giant left anterior descending artery aneurysm. The CAA was successfully treated by surgical resection and a mammary artery bypass graft.
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Affiliation(s)
- E Yaşar
- Malatya Training and Research Hospital
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Mezzetti E, Costantino A, Leoni M, Pieretti R, Di Paolo M, Frati P, Maiese A, Fineschi V. Autoimmune Heart Disease: A Comprehensive Summary for Forensic Practice. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1364. [PMID: 37629654 PMCID: PMC10456745 DOI: 10.3390/medicina59081364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 07/05/2023] [Accepted: 07/20/2023] [Indexed: 08/27/2023]
Abstract
Autoimmune heart disease is a non-random condition characterised by immune system-mediated aggression against cardiac tissue. Cardiac changes often exhibit nonspecific features and, if unrecognised, can result in fatal outcomes even among seemingly healthy young individuals. In the absence of reliable medical history, the primary challenge lies in differentiating between the various cardiopathies. Numerous immunohistochemical and genetic studies have endeavoured to characterise distinct types of cardiopathies, facilitating their differentiation during autopsy examinations. However, the presence of a standardised protocol that forensic pathologists can employ to guide their investigations would be beneficial. Hence, this summary aims to present the spectrum of autoimmune cardiopathies, including emerging insights such as SARS-CoV-2-induced cardiopathies, and proposes the utilisation of practical tools, such as blood markers, to aid forensic pathologists in their routine practice.
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Affiliation(s)
- Eleonora Mezzetti
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, Institute of Legal Medicine, University of Pisa, 56126 Pisa, Italy; (E.M.); (A.C.); (M.L.); (R.P.); (M.D.P.)
| | - Andrea Costantino
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, Institute of Legal Medicine, University of Pisa, 56126 Pisa, Italy; (E.M.); (A.C.); (M.L.); (R.P.); (M.D.P.)
| | - Matteo Leoni
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, Institute of Legal Medicine, University of Pisa, 56126 Pisa, Italy; (E.M.); (A.C.); (M.L.); (R.P.); (M.D.P.)
| | - Rebecca Pieretti
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, Institute of Legal Medicine, University of Pisa, 56126 Pisa, Italy; (E.M.); (A.C.); (M.L.); (R.P.); (M.D.P.)
| | - Marco Di Paolo
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, Institute of Legal Medicine, University of Pisa, 56126 Pisa, Italy; (E.M.); (A.C.); (M.L.); (R.P.); (M.D.P.)
| | - Paola Frati
- Department of Anatomical, Histological, Forensic and Orthopedical Sciences, Sapienza University of Rome, Viale Regina Elena 336, 00161 Rome, Italy; (P.F.); (V.F.)
| | - Aniello Maiese
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, Institute of Legal Medicine, University of Pisa, 56126 Pisa, Italy; (E.M.); (A.C.); (M.L.); (R.P.); (M.D.P.)
| | - Vittorio Fineschi
- Department of Anatomical, Histological, Forensic and Orthopedical Sciences, Sapienza University of Rome, Viale Regina Elena 336, 00161 Rome, Italy; (P.F.); (V.F.)
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Hu HO, Zhang CH, Spadaccio C, Tang B, Li CN, Qiao ZY, Zheng T, Zhu JM, Sun LZ. Surgical management of aortic regurgitation secondary to Behcet's disease. Front Cardiovasc Med 2023; 10:1093024. [PMID: 37008328 PMCID: PMC10064057 DOI: 10.3389/fcvm.2023.1093024] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 03/02/2023] [Indexed: 03/19/2023] Open
Abstract
BackgroundAortic regurgitation (AR) related to Behcet's disease (BD) is rare, but usually fatal. Perivalvular leakage (PVL) is high if AR related to BD treated with regular AVR. In this study, we report the surgical management of AR secondary to BD.MethodsBetween September 2017 and April 2022, 38 patients with AR secondary to Behcet's disease had surgery in our center. 17 patients did not have a BD diagnosis before surgery, 2 of them were diagnosed during surgery and received Bentall procedure. The remaining 15 patients received conventional AVR. 21 patients were diagnosed as BD before surgery, all of them received modified Bentall procedures. All patients were followed up by regular outpatient visits, transthoracic echocardiogram and CT angiography were performed to evaluate the aorta and aortic valve.ResultsSeventeen patients did not have a BD diagnosis at the time of surgery. Out of them, 15 patients received conventional AVR, and a total of 13 patients suffered PVL after surgery. Twenty-one patients had a BD diagnosis before surgery. They received modified Bentall procedures and IST and steroids were given both pre- and post-surgery. In this group treated with Bentall procedure no patient suffered PVL during follow up.ConclusionsPVL is a complex scenario after conventional AVR for AR in BD. Modified Bentall procedure seems superior to isolated AVR in these cases. The use of IST and steroids before and after surgery in combination with modified Bentall procedure could have a role in effectively reducing PVL.
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Affiliation(s)
- Hai-Ou Hu
- Department of Cardiovascular Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing Aortic Disease Center, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing, China
| | - Chen-Han Zhang
- Department of Cardiovascular Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing Aortic Disease Center, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing, China
| | - Cristiano Spadaccio
- Department of Cardiovascular Surgery, Mayo Clinic, Rochester, MN, United States
| | - Bing Tang
- Department of Cardiovascular Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing Aortic Disease Center, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing, China
| | - Cheng-Nan Li
- Department of Cardiovascular Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing Aortic Disease Center, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing, China
| | - Zhi-Yu Qiao
- Department of Cardiovascular Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing Aortic Disease Center, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing, China
| | - Tie Zheng
- Department of Cardiovascular Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing Aortic Disease Center, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing, China
| | - Jun-Ming Zhu
- Department of Cardiovascular Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing Aortic Disease Center, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing, China
- Correspondence: Zhu Jun-Ming
| | - Li-Zhong Sun
- Department of Cardiovascular Surgery, DeltaHealth Hospital·Shanghai, Shanghai, China
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Transthoracic echocardiographic assessment of cardiac valves in patients with Behçet’s disease. Int J Cardiovasc Imaging 2022; 39:697-706. [PMID: 36460877 DOI: 10.1007/s10554-022-02769-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 11/24/2022] [Indexed: 12/04/2022]
Abstract
The main objectives of the current study are to investigate valvular involvement in patients with cardiac Behçet's disease (BD) and find out the risk factors of valvular involvement in cardiac BD. We retrospectively assessed the clinical and echocardiographic data in the medical records of 121 patients with BD admitted to Beijing Anzhen Hospital from January 2015 to January 2022. We evaluated the valvular structure and function mainly by echocardiography. A total of 77 BD patients (77/121, 63.64%) had cardiac valvular involvement. Valvular lesions occurred more frequently in males (p = 0.022). Aortic regurgitation (AR) (62/77, 80.52%) was the most common finding and severe AR occupied 80.65% (50/62). The most common manifestations of BD patients with severe AR was aortic valve prolapse (25/50, 50%), followed by echo-free spaces within the aortic annulus (11/50, 22%), vegetation-like lesions (10/50, 20%), and aortic root aneurysm (10/50, 20%). The incidence of paravalvular leaks (PVL) in BD patients was 14.29% (7/49). The diameter of the sinus of Valsalva and proximal ascending aorta, and total cholesterol (TCHO) were the independent risk factors of moderate-severe aortic valvular regurgitation (p < 0.01). Left ventricular end-diastolic dimension (LVEDD), left ventricular ejection fraction (LVEF) and brain natriuretic peptide (BNP) were significantly associated with moderate-severe mitral valvular regurgitation (p < 0.01). The most common valvular abnormality in BD is AR. Echocardiography has great value in the comprehensive evaluation and accurate diagnosis of valvular involvement in BD patients.
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Mazzoni C, Scheggi V, Mariani T. Cardiac involvement in Behçet disease presenting as non-bacterial thrombotic endocarditis: A case report. J Cardiol Cases 2022; 24:157-160. [PMID: 35059048 DOI: 10.1016/j.jccase.2021.03.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 02/15/2021] [Accepted: 03/10/2021] [Indexed: 01/09/2023] Open
Abstract
Behçet disease (BD) is a form of widespread vasculitis that involves both arteries and veins. Cardiac involvement in BD is exceedingly rare and can present as a form of non-bacterial- thrombotic-endocarditis (NBTE). A 54-year-old man with Behçet disease was admitted to our hospital after presenting with abdominal pain and fever. He had been recently discharged from a hospital in another country with the diagnosis of infective endocarditis of the mitral valve and mycotic embolization to the superior mesenteric artery. At presentation, oral and genital ulcers were present, raising the suspicion of a flare of BD. Transesophageal echocardiography showed a small vegetation on the anterior leaflet of the mitral valve. Blood cultures results were negative. Computed tomography of the abdomen showed extensive inferior vena cava thrombosis. The aneurysm and thrombotic phenomena were interpreted as related to BD: the vegetation on the mitral valve was diagnosed as NBTE of which BD is a recognized cause. With corticosteroid and anticoagulant therapy, the patient's symptoms steadily improved. NBTE is a rare manifestation of BD; differential diagnosis with infective endocarditis can be challenging and should be focused on identifying predisposing conditions. The mainstay of treatment in NBTE is medical therapy with anticoagulation and treatment of the underlying disease. <Learning objective: Cardiac involvement in the setting of Behçet Disease (BD) is rare and several different manifestations are described (intracardiac thrombus, non-infective endocarditis, myocarditis, pericarditis, endomyocardial fibrosis, coronary arteritis). Non-bacterial thrombotic endocarditis (NBTE) is also a rare finding which can happen in the setting of BD. Its prevalence is unknown and evidence is derived only from scarce case reports.The role of BD as a potential cause of NBTE must be acknowledged to avoid potential misdiagnosis.>.
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Affiliation(s)
- Carlotta Mazzoni
- Division of Cardiology, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Italy
- Cardiothoracovascular Department, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Largo Brambilla 3, Florence 50133, Italy
| | - Valentina Scheggi
- Cardiothoracovascular Department, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Largo Brambilla 3, Florence 50133, Italy
- Division of Cardiovascular and Perioperative Medicine, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Italy
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Demirbaş A, Elmas ÖF, Demirbaş GU, Atasoy M, Türsen Ü, Lotti T. Potential Utility of Oral Mucosal Capillaroscopy as an Indicator of Microvascular Damage in Behçet Disease: A Preliminary Study. Dermatol Pract Concept 2021; 11:e2021116. [PMID: 34631265 DOI: 10.5826/dpc.1104a116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/28/2020] [Indexed: 10/31/2022] Open
Abstract
Introduction Behçet disease (BD) is an auto-inflammatory condition characterized by multisystemic vasculitis. Oral mucosal capillaroscopy is an easy-to-use, repeatable, non-invasive method for evaluating mucosal microvasculature, contributing to the differential diagnosis and prognosis of various acute and chronic inflammatory diseases. Objectives This study aims to characterize and describe the oral labial mucosal capillary findings in patients with BD using handheld dermatoscopy and to investigate the relationship between the capillary findings and the severity of the disease. Methods This cross-sectional study included patients with BD and healthy subjects. Capillaroscopic examination of the oral labial mucosa in each subject was performed by a handheld dermatoscope using polarized light. The clinical severity of BD was evaluated using Krause's Clinical Severity Scoring for BD. Results Sixty patients with BD and 60 healthy subjects were enrolled in the study. The frequencies of irregular capillaries, microhemorrhages, glomerular vessels, megacapillaries, and tortuous vessels were statistically significantly higher in the patient group when compared to the healthy individuals. In addition, a correlation was detected between the oral mucosal capillaroscopic findings and disease duration, severity, and vascular complications. Conclusions Our study is the first to explore the potential role of oral mucosal capillaroscopic examination in patients with BD. Data obtained from this study indicated that oral mucosal capillaroscopy may be a useful tool to demonstrate microvascular damage in patients with BD.
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Affiliation(s)
| | - Ömer Faruk Elmas
- Department of Dermatology, Kırıkkale University Kırıkkale, Turkey
| | - Gözde Ulutaş Demirbaş
- Department of Dermatology, Evliya Çelebi Training and Research Hospital, Kütahya, Turkey
| | - Mustafa Atasoy
- Health Science University, Kayseri City Hospital, Department of Dermatology, Kayseri, Turkey
| | - Ümit Türsen
- Mersin University, Department of Dermatology, Mersin, Turkey
| | - Torello Lotti
- Department of Dermatology, Guglielmo Marconi University, Rome, Italy
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Sunbul M, Midi IG, Agackiran SK, Engin E, Ucem S, Alibaz-Oner F, Sayar N, Direskeneli H, Sadıc BO. Myocardial involvement in Behçet's disease may be higher in patients with Neuro-Behçet's disease: a speckle tracking echocardiographic study. Acta Cardiol 2021; 77:515-523. [PMID: 34392811 DOI: 10.1080/00015385.2021.1965354] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND 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. METHODS 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). RESULTS 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. CONCLUSIONS 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.
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Affiliation(s)
- Murat Sunbul
- Department of Cardiology, Marmara University School of Medicine, Istanbul, Turkey
| | - Ipek Gursoy Midi
- Department of Neurology, Marmara University School of Medicine, Istanbul, Turkey
| | - Seda Kutlug Agackiran
- Department of Internal Medicine, Division of Rheumatology, Marmara University School of Medicine, Istanbul, Turkey
| | - Esin Engin
- Department of Neurology, Marmara University School of Medicine, Istanbul, Turkey
| | - Selen Ucem
- Marmara University School of Medicine, Istanbul, Turkey
| | - Fatma Alibaz-Oner
- Department of Internal Medicine, Division of Rheumatology, Marmara University School of Medicine, Istanbul, Turkey
| | - Nurten Sayar
- Department of Cardiology, Marmara University School of Medicine, Istanbul, Turkey
| | - Haner Direskeneli
- Department of Internal Medicine, Division of Rheumatology, Marmara University School of Medicine, Istanbul, Turkey
| | - Beste Ozben Sadıc
- Department of Cardiology, Marmara University School of Medicine, Istanbul, Turkey
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Stein NR, Ramakrishna S, Yeghiazarians Y. Premature coronary disease, in-stent restenosis and vascular complications in a young man with Behçet syndrome. BMJ Case Rep 2020; 13:e235039. [PMID: 32843407 PMCID: PMC7449362 DOI: 10.1136/bcr-2020-235039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/07/2020] [Indexed: 11/03/2022] Open
Abstract
A young man with a history of early-onset coronary disease presented with an ST-elevation myocardial infarction at the age of 38. He subsequently had recurrent in-stent restenosis requiring repeating interventions and ultimately bypass surgery. After 4 years, he presents with systemic symptoms, new skin lesions and a femoral artery pseudoaneurysm. He is diagnosed with Behçet syndrome, a rare systemic vasculitis characterised by the triad of oral aphthous ulcers, genital ulcers and ocular involvement. Behçet is not associated with premature coronary disease but can have a variety of cardiac complications. Additionally, pathergy, an exaggerated inflammatory response to local injury, is characteristic. We hypothesise that in retrospect, subclinical inflammation and a vascular pathergy likely predisposed him to his cardiac and vascular complications. Here, we review risk factors and presentation of premature coronary artery disease and review the literature on the cardiovascular complications of Behçet syndrome.
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Affiliation(s)
- Nathan R Stein
- Department of Internal Medicine, University of California San Francisco, San Francisco, California, USA
| | - Satvik Ramakrishna
- Department of Internal Medicine, Division of Cardiology, University of California San Francisco, San Francisco, California, USA
| | - Yerem Yeghiazarians
- Department of Internal Medicine, Division of Cardiology, University of California San Francisco, San Francisco, California, USA
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Chen H, Zhang Y, Li C, Wu W, Liu J, Zhang F, Zheng W. Coronary involvement in patients with Behçet’s disease. Clin Rheumatol 2019; 38:2835-2841. [DOI: 10.1007/s10067-019-04640-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 05/10/2019] [Accepted: 06/04/2019] [Indexed: 11/28/2022]
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Cardiovascular involvement in systemic rheumatic diseases: An integrated view for the treating physicians. Autoimmun Rev 2018; 17:201-214. [DOI: 10.1016/j.autrev.2017.12.001] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2017] [Accepted: 10/12/2017] [Indexed: 02/07/2023]
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12
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Khederlou H, Taheri S, Sadeghi A, Moghtader Mojdehi A. Dilated Cardiomyopathy in Behcet′s Disease in a Young Male Patient. INTERNATIONAL JOURNAL OF CARDIOVASCULAR PRACTICE 2017. [DOI: 10.21859/ijcp-030102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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13
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Spontaneous Right Coronary Artery Rupture and Acute Cardiac Tamponade in Behçet's Disease. Heart Lung Circ 2016; 25:e149-e151. [DOI: 10.1016/j.hlc.2016.04.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2016] [Revised: 04/11/2016] [Accepted: 04/23/2016] [Indexed: 11/23/2022]
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Choi JY, Kim SH, Kwok SK, Jung JI, Lee KY, Kim TJ, Kang JY. A 30-year-old female Behçet's disease patient with recurrent pleural and pericardial effusion and elevated adenosine deaminase levels: case report. J Thorac Dis 2016; 8:E547-51. [PMID: 27499994 DOI: 10.21037/jtd.2016.05.88] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Behçet's disease is a systemic disease which may involve various organs. We describe a case of a patient diagnosed as pleuropericardial involvement of Behçet's disease. A 30-year-old woman visited our clinic presented with left pleuritic chest pain for s days. She had been diagnosed as Behçet's disease and admitted to our clinic due to pericardial and pleural effusion repeatedly in past two years. In the previous studies, effusion analysis revealed to be lympho-dominant exudate with high adenosine deaminase level. Acid-fast bacilli (AFB) culture and polymerase chain reaction (PCR) for mycobacterial tuberculosis (M.TB) were negative in the pericardial tissue, and pathologic finding showed mild endothelitis with micro-thrombi formation in the lumen. The patient had been treated with antituberculous medication for a year. In the current admission, chest computed tomography (CT) again showed left pleural effusion without other significant lesion. Pleural fluid analysis was similar with the previous study. Video-assisted thoracoscopic pleural biopsy was performed to obtain the definite diagnosis. Pathology confirmed the diagnosis as pleuropericardial involvement of Behçet's disease, and we treated the patient with oral steroid in the out-patient department. Pleuropericardial involvement of Behçet's disease may mimic TB pleurisy or pericarditis due to high adenosine deaminase (ADA) level in effusion analysis. Clinicians should keep in mind that Behçet's disease may manifest as pleural or pericardial effusion, and pathologic confirmation could be helpful for the definite diagnosis.
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Affiliation(s)
- Joon Young Choi
- Department of Internal Medicine, College of Medicine, the Catholic University of Korea, Seoul, Korea
| | - Sung-Hwan Kim
- Department of Internal Medicine, College of Medicine, the Catholic University of Korea, Seoul, Korea
| | - Seung-Ki Kwok
- Department of Internal Medicine, College of Medicine, the Catholic University of Korea, Seoul, Korea
| | - Jung Im Jung
- Department of Radiology, College of Medicine, the Catholic University of Korea, Seoul, Korea
| | - Kyo-Young Lee
- Department of Clinical Pathology, College of Medicine, the Catholic University of Korea, Seoul, Korea
| | - Tae-Jung Kim
- Department of Clinical Pathology, College of Medicine, the Catholic University of Korea, Seoul, Korea
| | - Ji Young Kang
- Department of Internal Medicine, College of Medicine, the Catholic University of Korea, Seoul, Korea
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Díez-Delhoyo F, Sanz-Ruiz R, Casado-Plasencia A, Rivera-Juárez A, Gutiérrez-Ibañes E, Sarnago-Cebada F, Vázquez-Álvarez ME, Clavero-Olmos M, Elízaga J, Fernández-Avilés F. Not just thrombi occlude coronary arteries in Behçet's disease: A case of spontaneous coronary artery dissection. Int J Cardiol 2016; 214:317-9. [DOI: 10.1016/j.ijcard.2016.03.208] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Accepted: 03/27/2016] [Indexed: 11/26/2022]
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Yoon HY, Park SH, Jeung SM, Seo YR, Seo BM, Kim SH, Yoo B. A Case of Cardiac Behçet’s Disease Mimicking Culture-Negative Infective Endocarditis. ACTA ACUST UNITED AC 2015. [DOI: 10.3904/kjm.2015.89.2.249] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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17
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Veilleux SP, O'Connor K, Couture C, Pagé S, Voisine P, Poirier P, Dubois M, Sénéchal M. What the Cardiologist Should Know About Cardiac Involvement in Behçet Disease. Can J Cardiol 2015. [PMID: 26215987 DOI: 10.1016/j.cjca.2015.04.030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
Behçet disease (BD) is a chronic multisystem inflammatory vasculitis affecting mainly young adults and is characterized by a remitting-relapsing course. In North America, the prevalence is 5.2 per 100,000 population. It is believed that cardiac involvement is one of the most severe complications in patients with BD despite its sporadic occurrence, being greatly correlated with mortality.
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Affiliation(s)
- Simon-Pierre Veilleux
- Department of Cardiology, Institut universitaire de cardiologie et de pneumologie de Québec, Québec City, Canada
| | - Kim O'Connor
- Department of Cardiology, Institut universitaire de cardiologie et de pneumologie de Québec, Québec City, Canada
| | - Christian Couture
- Department of Anatomo Pathology, Institut universitaire de cardiologie et de pneumologie de Québec, Québec City, Canada
| | - Sylvain Pagé
- Department of Anatomo Pathology, Institut universitaire de cardiologie et de pneumologie de Québec, Québec City, Canada
| | - Pierre Voisine
- Department of Cardiac Surgery, Institut universitaire de cardiologie et de pneumologie de Québec, Québec City, Canada
| | - Paul Poirier
- Department of Cardiology, Institut universitaire de cardiologie et de pneumologie de Québec, Québec City, Canada
| | - Michelle Dubois
- Department of Cardiology, Institut universitaire de cardiologie et de pneumologie de Québec, Québec City, Canada
| | - Mario Sénéchal
- Department of Cardiology, Institut universitaire de cardiologie et de pneumologie de Québec, Québec City, Canada.
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Farouk H, Chilali KE, Said K, Sakr B, Salah H, Mahmoud G, Sorour K. Value of certain echocardiographic findings in the initial suspicion of Behçet's disease. Echocardiography 2015; 31:924-30. [PMID: 25208862 DOI: 10.1111/echo.12601] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
PURPOSE To describe the echocardiographic findings detected as first manifestations of Behçet's disease (BD) and compare these findings with those detected in established cases of BD receiving regular medical treatment. METHODS Two groups of patients were studied. Group 1 comprised 41 patients with BD on regular medical treatment. Group 2 comprised 5 previously healthy patients who presented to the cardiology department because of cardiac symptoms and were diagnosed in retrospect during hospitalization as BD. Thirty-two age- and sex-matched individuals served as control subjects (control group). All patients and controls underwent complete M-mode, two-dimensional, and Doppler transthoracic echocardiographic examinations. RESULTS Of the 41 treated patients with BD (mean age: 32 ± 8 years, 90% males, mean duration since diagnosis: 14.5 years), only 1 patient was found to have severe aortic regurgitation secondary to aortic root dilation. On the other hand, the 5 previously healthy patients who presented with cardiac symptoms (mean age: 24 ± 6 years, all males) had significant cardiac involvement and evident echocardiographic findings (P < 0.001). Four cases had intracardiac masses: 3 in the right atrium (RA), 1 in the right ventricle (RV), while the last patient had pericardial effusion (PE). All these patients were diagnosed in retrospect as BD. The RA masses disappeared on medical therapy, while the RV mass was surgically excised and proved to be multiple thrombi histopathologically. The patient with PE had recurrent attacks of massive effusion so a pericardial window was performed surgically. CONCLUSION Diagnosis of BD might be initially suspected by the cardiologists based on certain echocardiographic findings, namely the presence of right-sided masses. Diagnosis of BD in such patients has important therapeutic implications and accordingly prognostic value.
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Affiliation(s)
- Heba Farouk
- Cardiovascular Medicine Department, Cairo University Hospital, Cairo, Egypt
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Pandey A, Garg J, Krishnamoorthy P, Palaniswamy C, Doshi J, Lanier G, Ahmad H. Predictors of Coronary Artery Disease in Patients with Behçet's Disease. Cardiology 2014; 129:203-6. [DOI: 10.1159/000365139] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2014] [Accepted: 06/06/2014] [Indexed: 11/19/2022]
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Eldin AB, Ibrahim A. Assessment of the relationship between vascular endothelial growth factor and cardiovascular involvement in Egyptian patients with Behçet’s disease. EGYPTIAN RHEUMATOLOGIST 2014. [DOI: 10.1016/j.ejr.2013.12.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Yurdakul S, Erdemir VA, Tayyareci Y, Yildirimturk O, Salih Gurel M, Aytekin S. Subclinical left and right ventricular systolic dysfunction in Behcet's disease: a combined tissue doppler and velocity vector imaging study. JOURNAL OF CLINICAL ULTRASOUND : JCU 2013; 41:347-353. [PMID: 22941470 DOI: 10.1002/jcu.21985] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2012] [Accepted: 08/06/2012] [Indexed: 06/01/2023]
Abstract
BACKGROUND Behcet's disease (BD) is a chronic inflammatory disease characterized by recurrent oral and genital ulcerations and ocular lesions. Subclinical cardiac involvement may develop in BD patients. We aimed to evaluate subclinical left ventricular (LV) and right ventricular (RV) systolic dysfunction in BD patients without any apparent cardiovascular disease. METHODS We studied 50 BD patients (43.8 ± 9.7 years, 59% men) and 30 healthy controls (45.4 ± 8.2 years, 60% men). Conventional echocardiography, tissue Doppler imaging, and velocity vector imaging-based strain measurements were performed to analyze LV and RV systolic functions. RESULTS LV isovolumic myocardial acceleration, peak systolic velocity during isovolumic contraction (isovolumic contraction velocity), were significantly lower, while myocardial performance index was increased in BD patients. RV peak systolic velocity, isovolumic myocardial acceleration, and isovolumic contraction velocity were also markedly lower in BD patients. LV and RV longitudinal peak systolic strain and strain rate were significantly lower in patients than in controls, demonstrating subclinical ventricular systolic dysfunction. CONCLUSIONS Ventricular long-axis functions are important markers of myocardial contractility. Novel echocardiographic techniques may provide additional data for detecting early deterioration in ventricular systolic function in patients with BD.
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Affiliation(s)
- Selen Yurdakul
- Florence Nightingale Hospital, Cardiology Division, Istanbul, Turkey
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Maeshima K, Ishii K, Inoue M, Himeno K, Seike M. Behçet’s disease complicated by multiple aseptic abscesses of the liver and spleen. World J Gastroenterol 2013; 19:3165-3168. [PMID: 23717000 PMCID: PMC3662960 DOI: 10.3748/wjg.v19.i20.3165] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2012] [Revised: 01/31/2013] [Accepted: 03/09/2013] [Indexed: 02/06/2023] Open
Abstract
Aseptic abscesses are an emergent entity and have been described in inflammatory bowel disease, especially in Crohn’s disease, and in other diseases. However, aseptic abscesses associated with Behçet’s disease are extremely rare. We report a Japanese male diagnosed with an incomplete type of Behçet’s disease who developed multiple aseptic abscesses of the spleen and liver. In 2002, the spleen abscesses were accompanied by paroxysmal oral aphthous ulcers and erythema nodosum. As the patient’s response to antibiotic treatment was inadequate, a splenectomy was performed. Severe inflammatory cell infiltration, largely of polymorphonuclear neutrophils, was observed without evidence of bacterial or fungal growth. Although the patient had no history of ocular symptoms or genital ulcers, a diagnosis of incomplete Behçet’s disease was made according to the Japanese diagnostic criteria because of the presence of paroxysmal arthritis and epididymitis since 2002. In 2005, multiple liver abscesses developed with right hypochondrial pain and seemed to be attributed to Behçet’s disease because the abscesses yielded negative results during a microbiologic investigation and failed to go into remission under antibiotic therapy. Oral prednisone (15 mg/d) was started in May 2006, and the abscesses dramatically disappeared 4 wk after treatment. Although the patient had a relapse of the liver abscesses in association with the tapering of prednisone, the augmentation of prednisone dosage yielded a response. The abscesses of the liver and spleen were strongly suggested to be attributed to Behçet’s disease. Clinician should be aware of the existence of aseptic abscesses as uncommon manifestations of Behçet’s disease.
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Owlia MB, Mehrpoor G. Behcet's Disease: New Concepts in Cardiovascular Involvements and Future Direction for Treatment. ISRN PHARMACOLOGY 2012; 2012:760484. [PMID: 22530146 PMCID: PMC3317002 DOI: 10.5402/2012/760484] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/17/2011] [Accepted: 12/15/2011] [Indexed: 01/02/2023]
Abstract
Behcet's disease (BD) is the only systemic vasculitis involving both arteries and vein in any sizes. It frequently encounters in rheumatology clinics. It has some major morbidities and even fatal outcomes in some cases. The aim of this paper is to analyze the main concepts on pathophysiology and treatment options in BD, focusing on cardiovascular aspects, thrombosis, and potential future treatment.
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Affiliation(s)
- M. B. Owlia
- Division of Rheumatology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - G. Mehrpoor
- Division of Rheumatology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Spiliotopoulos K, Yanagawa B, Crean A, Overgaard C, Brister SJ. Surgical management of a left anterior descending pseudoaneurysm related to Behcet's disease. Ann Thorac Surg 2011; 91:912-4. [PMID: 21353029 DOI: 10.1016/j.athoracsur.2010.08.066] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2010] [Revised: 08/18/2010] [Accepted: 08/30/2010] [Indexed: 10/18/2022]
Abstract
A 22-year-old woman suffering from Behcet's disease and severe angina was diagnosed with a left anterior descending coronary artery giant pseudoaneurysm. Preoperative investigations, surgical management, and its principles, as well as specific postoperative follow-up considerations are described.
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Affiliation(s)
- Konstantinos Spiliotopoulos
- Division of Cardiovascular Surgery, Peter Munk Cardiac Centre, Toronto General Hospital, Toronto, Ontario, Canada.
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Tian Z, Zhang S, Wu Q. Recurrent variant angina pectoris due to Behçet's syndrome. Intern Med 2011; 50:2587-9. [PMID: 22041362 DOI: 10.2169/internalmedicine.50.5727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
We report a case of recurrent variant angina pectoris which occurred even while receiving antispastic treatment. Coronary angiography revealed no obvious lesion. Behçet's syndrome was diagnosed based on recurrent oral aphthous and genital ulcer as well as skin manifestation. After treatment with immunosuppressant, neither angina nor oral ulcer relapsed. We strongly believe that the variant angina is due to coronary vasospasm induced by Behçet's syndrome in this patient.
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Affiliation(s)
- Zhuang Tian
- Department of Cardiology, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, China
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Hashimoto K, Ichiyama T, Hasegawa M, Hasegawa S, Matsubara T, Furukawa S. Cysteinyl Leukotrienes Induce Monocyte Chemoattractant Protein-1 in Human Monocyte/Macrophages via Mitogen-Activated Protein Kinase and Nuclear Factor-κB Pathways. Int Arch Allergy Immunol 2009; 149:275-82. [DOI: 10.1159/000199724] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2008] [Accepted: 10/07/2008] [Indexed: 11/19/2022] Open
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