Spectrum of Cardiac Lesions in Behcet Disease A Series of 52 Patients and Review of the Literature

被引:187
作者
Geri, Guillaume [2 ]
Wechsler, Bertrand [2 ]
Du Le Thi Huong [2 ]
Isnard, Richard [3 ]
Piette, Jean-Charles [2 ]
Amoura, Zahir [2 ]
Resche-Rigon, Mathieu [4 ]
Cacoub, Patrice [2 ]
Saadoun, David [1 ,2 ]
机构
[1] Univ Paris 06, Hop La Pitie Salpetriere, Dept Internal Med, CNRS,INSERM,UPMC,U959,UMR 7211, F-75013 Paris, France
[2] Grp Hosp Pitie Salpetriere, Assistance Publ Hop Paris, Serv Med Interne 2, F-75634 Paris, France
[3] Grp Hosp Pitie Salpetriere, Assistance Publ Hop Paris, Serv Cardiol, F-75634 Paris, France
[4] Grp Hosp St Louis, Assistance Publ Hop Paris, Dept Biostat, Paris, France
关键词
ACUTE MYOCARDIAL-INFARCTION; CEREBRAL VENOUS THROMBOSIS; LEFT-VENTRICULAR ANEURYSM; CARDIOVASCULAR INVOLVEMENT; ACUTE PERICARDITIS; ENDOMYOCARDIAL FIBROSIS; INTRACARDIAC THROMBUS; DIASTOLIC DYSFUNCTION; ARTERY INVOLVEMENT; PROGNOSTIC-FACTORS;
D O I
10.1097/MD.0b013e3182428f49
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Cardiac abnormalities in patients with Behcet disease (BD) include pericarditis, myocarditis, endocarditis with valvular regurgitation, intracardiac thrombosis, endomyocardial fibrosis, coronary arteritis with or without myocardial infarction, and aneurysms of the coronary arteries or sinus of Valsalva. Data regarding the clinical spectrum, prevalence, and outcome of cardiac lesions in BD are lacking. In this study, we report the main characteristics, treatment, and long-term outcomes of 52 patients with cardiac lesions from a cohort of 807 (6%) BD patients. Forty-five (86.5%) patients were male, with a mean (+/-SD) age at BD diagnosis of 29.3 +/- 10.3 years. Cardiac involvement was the first feature of BD in 17 (32.7%) patients. Cardiac lesions included pericarditis (n = 20; 38.5%), endocarditis (mostly aortic insufficiency) (n = 14; 26.9%), intracardiac thrombosis (n = 10; 19.2%), myocardial infarction (n = 9; 17.3%), endomyocardial fibrosis (n = 4; 7.7%) and myocardial aneurysm (n = 1; 1.9%). Patients with cardiac involvement were more frequently male (86.5% vs. 64.9%; p < 0.01) and had more arterial (42.3% vs. 11.1%; p < 0.01) and venous lesions (59.6% vs. 35.8%; p < 0.01) compared to those without cardiac manifestations. Factors associated with complete remission of cardiac involvement were treatment regimens with oral anticoagulants, immunosuppressants, and colchicine. The 5-year survival rate was 83.6% and 95.8% (p = 0.03) in BD patients with and without cardiac involvement, respectively. After a median (Q1-Q3) follow-up of 3.0 (1.75-4.2) years, 8 patients had died, in 3 cases directly related to cardiac involvement. In conclusion, cardiac lesions affected 6% of our large cohort of BD patients. The prognosis of cardiac involvement in BD is poor and improves with oral anticoagulation, immunosuppressive therapy, and colchicine.
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收藏
页码:25 / 34
页数:10
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