Aktuelle Rheumatologie 2013; 38(05): 309-320
DOI: 10.1055/s-0033-1357186
Übersichtsarbeit
© Georg Thieme Verlag KG Stuttgart · New York

Complications of the Heart and Great Vessels due to Behçet’s Disease: A Comprehensive Review

Kardiale und Vaskuläre Komplikationen bei M. Behçet: eine Literaturübersicht
S.-M. Yuan
1   Department of Cardiothoracic Surgery, The First Hospital of Putian, Teaching Hospital, Fujian Medical University, Putian, Fujian Province, China
› Author Affiliations
Further Information

Publication History

Publication Date:
08 October 2013 (online)

Abstract

Background:

Cardiac involvements of Behçet disease are rare. However, the clinical features and prognoses warrant further elaborations.

Methods:

Data sources of this study relied on a comprehensive literature retrieval on cardiac complications of Behçet disease of years 2000–2013.

Results:

Cardiac complications developed more often in male and adult patients with Behçet disease. The pulmonary artery, aortic valve, superior vena cava and coronary arteries were the most commonly involved cardiac structures. Of them, 44.7% patients were surgically, 47.4% patients were conservatively, and 7.9% patients were interventionally treated. The patients with mono-site complications were associated with higher mortality than those with multi-site ones, and the ­surgical patients were presenting with higher mortality than the conservative and interventional patients. Morbidity of prosthetic valve dehiscence and mortality of the patients without immunosuppressive treatment were much higher than those with immunosuppressive agents (morbidity: 42.9% vs. 8.5%, p<0.0001; mortality: 42.9% vs. 9.9%, p<0.0001).

Conclusions:

The multisystem inflammatory nature with impaired immune function of patients with Behçet disease often leads to difficult management, high morbidity and mortality and poor prognosis. This study also implicates the importance of prompt diagnosis and timely treatment to the clinical prognoses of Behçet ­disease patients.

Zusammenfassung

Hintergrund:

Morbus Behçet (MB) tritt in seltenen Fällen in Verbindung mit einer Herzerkrankung auf. Die klinischen Merkmale und die Prognose von Patienten mit MB und Herzbeschwerden wurden bisher nicht ausreichend diskutiert.

Methode:

Grundlage dieser Überblickstudie ist eine umfassende Literaturrecherche der Jahre 2000–2013 zu Morbus Behçet mit Involvierung des Herzens.

Ergebnisse:

Herzkomplikationen traten am häu­figsten bei männlichen erwachsenen Patienten mit Morbus Behçet auf. Am häufigsten betroffen waren die A. pulmonalis, die Aortenklappe, die V. cava superior und die Herzkranzarterien. 44,7% der Patienten wurden einer Operation zugeführt, 47,4% der Patienten wurden konservativ und 7,9% der Patienten interventionell behandelt. Die Mortalität von Patienten mit fokalen Komplikationen war höher als bei Patienten mit multifokalen Komplikationen, und die Mortalität der operierten Patienten war höher als die Mortalität konservativ oder interventionell behandelter Patienten. Die Morbidität von Patienten mit Dehiszenz einer prosthetischen Klappe und die Mortalität von Patienten, die keine Immunsuppressiva erhielten, waren deutlich höher als bei Patienten, die mit Immunsuppressiva therapiert wurden (Morbidität: 42,9% vs. 8,5%, p<0,0001; Mortalität: 42,9% vs. 9,9%, p<0,0001).

Schlussfolgerungen:

Die multisystemische Natur dieser entzündlichen Erkrankung in Verbindung mit der beeinträchtigten Immunfunktion von Patienten mit MB erschweren das Krankheitsma­nagement. Die Morbidität und Mortalität sind hoch und die Prognose schlecht. Die Studie macht deutlich, wie wichtig Früherkennung und -behandlung für die klinische Prognose von Patienten mit MB sind.

 
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