Carotid artery intima-media thickness in Behcet's disease patients without significant cardiovascular involvement
1
조회
0
다운로드
3
인용
0
참고문헌
키워드
초록
Background/Aims : Behcet's disease (BD) is a systemic disorder associated with a characteristic vasculitis that can involve both veins and arteries of all sizes. Endothelial activation or injury is a characteristic feature of BD. Endothelial dysfunction is widely regarded as being the initial lesion in the development of atherosclerosis. The carotid artery intima-media thickness (IMT) is a widely accepted marker of subclinical atherosclerosis. We aimed to determine the carotid IMT in BD patients with using high-resolution B-mode Doppler ultrasonography. Methods : We studied 40 patients (24 males, mean age: 39.1±8.5 years) who were diagnosed by the international diagnostic criteria of Behcet's disease and 20 healthy controls (13 males, mean age: 40.2±5.1 years), and the two groups were matched by age and gender. No subject in either group had a history of atherosclerosis or its complications. The clinical data, including the age of onset, the duration of disease, a history of medication, the activity score and the laboratory data were analyzed. Results : The carotid IMT in the BD group was significantly higher than that in the control group (0.71±0.22 mm vs. 0.59±0.09 mm, respectively, p<0.01). Cardiac and major vessel involvements were not identified in the BD group. However, minor vascular involvements were documented in 2 patients with deep vein thrombosis, in 4 patients with superficial thrombophlebitis and in 2 patients with pseudoaneurysm. The carotid IMT in the patients with posterior uveitis or retinal vasculitis was higher than that of the patients without these findings (0.85±0.21 mm vs. 0.64±0.10 mm, respectively, p=0.007), but there was no difference of the IMT according to minor vascular involvement. Conclusions : Despite that there was no significant cardiovascular involvement in the BD patients, the carotid IMT was significantly higher in the BD patients as compared with the healthy controls.
Abstract
Background/Aims : Behcet's disease (BD) is a systemic disorder associated with a characteristic vasculitis that can involve both veins and arteries of all sizes. Endothelial activation or injury is a characteristic feature of BD. Endothelial dysfunction is widely regarded as being the initial lesion in the development of atherosclerosis. The carotid artery intima-media thickness (IMT) is a widely accepted marker of subclinical atherosclerosis. We aimed to determine the carotid IMT in BD patients with using high-resolution B-mode Doppler ultrasonography. Methods : We studied 40 patients (24 males, mean age: 39.1±8.5 years) who were diagnosed by the international diagnostic criteria of Behcet's disease and 20 healthy controls (13 males, mean age: 40.2±5.1 years), and the two groups were matched by age and gender. No subject in either group had a history of atherosclerosis or its complications. The clinical data, including the age of onset, the duration of disease, a history of medication, the activity score and the laboratory data were analyzed. Results : The carotid IMT in the BD group was significantly higher than that in the control group (0.71±0.22 mm vs. 0.59±0.09 mm, respectively, p<0.01). Cardiac and major vessel involvements were not identified in the BD group. However, minor vascular involvements were documented in 2 patients with deep vein thrombosis, in 4 patients with superficial thrombophlebitis and in 2 patients with pseudoaneurysm. The carotid IMT in the patients with posterior uveitis or retinal vasculitis was higher than that of the patients without these findings (0.85±0.21 mm vs. 0.64±0.10 mm, respectively, p=0.007), but there was no difference of the IMT according to minor vascular involvement. Conclusions : Despite that there was no significant cardiovascular involvement in the BD patients, the carotid IMT was significantly higher in the BD patients as compared with the healthy controls.
참고문헌 (28)
- Sakane T, "Behçet's disease", New England Journal of Medicine, 341, pp.1284~1291 (1999)
- Roguin A, "A fatal case of Behçet's disease associated with multiple cardiovascular lesions", INTERNATIONAL JOURNAL OF CARDIOLOGY, 59, pp.267~273 (1997)
- 한승우, "베체트병의 심혈관 침범", 대한내과학회지, 65(3), pp.542~560 (2003), 대한내과학회
- Danesh J, "Low grade inflammation and coronary heart disease: prospective study and updated meta-analyses", British Medical Journal, 321, pp.199~204 (2000)
- Bacon PA, "Accelerated atherogenesis in autoimmune rheumatic disease", AUTOIMMUNITY REVIEWS, 1, pp.338~347 (2002)
- Manzi S, "Prevalence and risk factors of carotid plaque in women with systemic lupus erythematosus", Arthritis and Rheumatism, 42, pp.51~60 (1999)
- Hingorani AD, "Acute systemic inflammation impairs endothelium- dependent dilatation in humans", Circulation, 102, pp.994~999 (2000)
- Raza K, "Suppression of inflammation in primary systemic vasculitis restores vascular endothelial function: lessons for atherosclerotic disease?", Circulation, 102, pp.1470~1472 (2000)
- Jorizzo JL, "Mucocutaneous criteria for the diagnosis of Behçet's disease: an analysis of clinicopathologic data from multiple international centers", JOURNAL OF THE AMERICAN ACADEMY OF DERMATOLOGY, 32, pp.968~976 (1995)
- Chambers JC, "Vascular endothelial function and oxidative stress mechanisms in patients with Behçet's syndrome", JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 37, pp.517~520 (2001)
- Ross R, "Atherosclerosis: an inflammatory disease", New England Journal of Medicine, 340, pp.115~126 (1999)
- Juonala M, "Interrelations between brachial endothelial function and carotid intima media thickness in young adults: the cardiovascular risk in young Finns study", Circulation, 110, pp.2918~2923 (2004)
- International Study Group for Behçet's Disease, "Criteria for diagnosis of Behçet's disease", Lancet, 335, pp.1078~1080 (1990)
- Krause I, "Pathergy reaction in Behçet’s disease: lack of correlation with mucocutaneous manifestations and systemic disease expression", CLINICAL AND EXPERIMENTAL RHEUMATOLOGY, 18, pp.71~74 (2000)
- Lee SS, "Fibromyalgia in Behçet's disease is associated with anxiety and depression, and not with disease activity", CLINICAL AND EXPERIMENTAL RHEUMATOLOGY, 23(4), pp.S15~S19 (2005)
- Pignoli P, "Intimal plus medial thickness of the arterial wall: a direct measurement with ultrasound imaging", Circulation, 74, pp.1399~1406 (1986)
- Keser G, "Increased thickness of the carotid artery intima-media assessed by ultrasonography in Behçet's disease", CLINICAL AND EXPERIMENTAL RHEUMATOLOGY, 23(4), pp.S71~S76 (2005)
- Numano F, "Vasa vasoritis, vasculitis and atherosclerosis", INTERNATIONAL JOURNAL OF CARDIOLOGY, 75, pp.S1~S8 (2000)
- Seyahi E, "Atherosclerosis in Takayasu arteritis", ANNALS OF THE RHEUMATIC DISEASES, 65, pp.1202~1207 (2006)
- de Leeuw K, "Accelerated atherosclerosis in patients with Wegener’s granulomatosis", ANNALS OF THE RHEUMATIC DISEASES, 64, pp.753~759 (2005)
- Ehrlich GE, "Vasculitis in Behçet's disease", INTERNATIONAL REVIEWS OF IMMUNOLOGY, 14, pp.81~88 (1997)
- Kosar F, "Acute myocardial infarction with normal coronary arteries in a young man with the Behcet's disease", INTERNATIONAL JOURNAL OF CARDIOLOGY, 99, pp.355~357 (2005)
- Persson J, "Ultrasound- determined intima-media thickness and atherosclerosis: direct and indirect validation", Arteriosclerosis and Thrombosis, 14, pp.261~264 (1994)
- Alan S, "Intima-media thickness and arterial distensibility in Behçet's disease", Angiology, 55, pp.413~419 (2004)
- Öztürk MA, "Morphologic evidence of subclinical atherosclerosis obtained by carotid ultrasonography in patients with Behcet's disease", RHEUMATOLOGY INTERNATIONAL, 26, pp.867~872 (2006)
- Moo-Yong Rhee, "Intima-media Thickness and Arterial Stiffness of Carotid Artery in Korean Patients with Behcet’s Disease", Journal of Korean Medical Science, 22(3), pp.387~392 (2007), 대한의학회
- 이무용, "Increased Arterial Stiffness in Behcet’s Disease Patients", Korean Circulation Journal, 36(10), pp.676~682 (2006), 대한심장학회
- Fichtlscherer S, "Elevated C-reactive protein levels and impaired endothelial vasoreactivity in patients with coronary artery disease", Circulation, 102, pp.1000~1006 (2000)