Aortic elastic properties and left ventricular diastolic function in patients with Adamantiades-Behcet's disease

Abstract

ObjectivesWe investigated whether Adamantiades-Behcet's disease (ABD) is related to impaired aortic (Ao) elastic properties and left ventricular (LV) function. BackgroundAdamantiades-Behcet's disease is an inflammatory disorder characterized by vasculitis leading to vascular complications and, rarely, myocarditis. MethodsWe studied 82 patients with ABD (age: 40 ± 12 years) and 24 normal control subjects by echocardiography. Abdominal Ao diameter (mm/m2) and Ao elastic indexes—namely, Ao strain (%), distensibility (cm2× dyn−1× 10−6), stiffness index, and pressure strain modulus (Ep) (cm2× dyn−1× 10−6)—were calculated from the echocardiographically derived thoracic Ao diameters (mm/m2), and the measurement of pulse pressure obtained by cuff sphygmomanometry. Isovolumic relaxation time (IVRT) (ms), deceleration time (DT) (ms), and flow propagation velocity (FPV) (cm/s) were measured by Doppler echocardiography to assess diastolic LV function. The duration of disease and presence of vascular complications were noted. ResultsPatients versus control subjects had increased Ao diameters (p < 0.01), lower mean Ao strain and distensibility (4 vs. 9 and 1.4 vs. 3.4, respectively, p < 0.01), higher mean aortic stiffness index and Ep (15.6 vs. 6 and 1.17 vs. 0.44, respectively, p < 0.01), and impaired IVRT and FPV (p < 0.01). Aortic function indexes were related to the duration of disease (p < 0.01) and increased DT (p < 0.01). Deceleration time >190 ms predicted vascular complications with 80% sensitivity and 71% specificity (odds ratio 6.52 [confidence interval: 2.23 to 19.03]). ConclusionAortic elastic properties and diastolic LV function are impaired in patients with ABD and are interrelated. The link between diastolic LV dysfunction and vascular complications suggests the presence of a common pathophysiologic pathway and provides a possible marker of risk for vascular disease.