Document Detail

Silent myocardial ischemia in Behçet's disease.
MedLine Citation:
PMID:  8882040     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Behçet's disease (BD) is a multisystemic disorder usually described as a triple symptom complex consisting of aphthous stomatitis, genital ulcerations, and uveitis. Vasculitis is a key feature of the disease, which may lead to functional disturbances in highly vascularized organs. However, cardiac involvement is seldom recognized. We investigated the prevalence of silent myocardial ischemia (SMI) in BD as the clinical presentation of microvascular disease. METHODS: Ambulatory cardiac monitoring (Holter) was used in 36 patients with BD to detect silent myocardial ischemia. 201Thallium myocardial perfusion scintigraphy and radionuclide ventriculography were also performed. All patients fulfilled International Study Group for Behçet's Disease criteria and 11 of them had major vascular involvement. The same method was also performed on 38 control subjects for comparison of SMI positivity in patients with BD. RESULTS: Ambulatory cardiac monitoring was performed for 9.2 +/- 0.9 h, mean heart rate was 82 +/- 9 bpm, and no serious rhythm disturbance was recorded. SMI was described in 9 of 36 patients (25%) (median age 38 years, range 30-46) as ST segment depression of 3.00 +/- 0.42 mm with a duration of 4.01 +/- 0.9 min. One SMI positivity only was recorded in the control group in a 52-year-old man with a stenotic lesion in the left anterior descending coronary artery (p < 0.001). Eight of 9 patients with SMI showed a partially reversible myocardial perfusion defect after exertion, and 7 demonstrated some degree of left ventricular wall motion abnormality by radionuclide ventriculography. Coronary angiography was normal in 7 of 9 patients with SMI. Additionally, 7 of 9 patients with SMI had major vascular involvement, while only 4 of 27 without SMI had major vascular disease (p = 0.0022). CONCLUSION: SMI incidence is significantly higher in BD compared to the control group. Impaired endothelial cell function may be the underlying cause in the pathogenesis of BD or of its vascular complications such as SMI.
I H Güllü; M Benekli; H Müderrisoğlu; A Oto; E Kansu; G Kabakçi; E Oram; C Bekdik
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of rheumatology     Volume:  23     ISSN:  0315-162X     ISO Abbreviation:  J. Rheumatol.     Publication Date:  1996 Feb 
Date Detail:
Created Date:  1996-12-17     Completed Date:  1996-12-17     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7501984     Medline TA:  J Rheumatol     Country:  CANADA    
Other Details:
Languages:  eng     Pagination:  323-7     Citation Subset:  IM    
Hacettepe University, Ankara, Turkey.
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MeSH Terms
Behcet Syndrome / complications*
Coronary Angiography
Electrocardiography, Ambulatory
Middle Aged
Myocardial Ischemia / complications*,  diagnosis,  physiopathology
Radionuclide Ventriculography
Thallium / diagnostic use
Reg. No./Substance:
Comment In:
J Rheumatol. 1996 Feb;23(2):211   [PMID:  8882019 ]

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