Background Behcet's disease is a kind of systemic vasculitis affecting multiple systems. Although symptomatic cardiac involvement in Behcet's disease is uncommon, the fatality rate may reach up to 29%. Conduction disturbances might lead to poor outcome and often need permanent pacemaker implanted. The characteristics of conduction disturbances in Behcet's disease were rarely reported before.

Objectives To investigate the clinical characteristics of Behcet's patients with conduction disturbances and explore the underlying risk factors.

Methods We reviewed 57 medical records of Behcet's disease with cardiovascular lesions in Anzhen Hospital, Capital Medical University between January 2002 and July 2015, and analyzed the clinical characteristics.

Results (1) There were 13 patients with conduction disturbances out of a total of 57 Behcet's disease cases (22.8%) in our research: three patients with first-degree atrioventricular block; one patient with Mobtizs type I second- degree atrioventricular block; four patients with third-degree atrioventricular block; one patient with the left anterior branch block; one patient with complete right bundle branch block; three patients with first-degree atrioventricular block combined with the left anterior branch block or complete right bundle branch block. One patient (7.7%) died from infectious endocarditis and aortic root abscess during hospital stay.

(2) Hemoglobin level was significantly lower in cases than controls (111.23±23.06 vs. 127.16±19.86 g/L, P=0.017); The median of albumin level in cases was higher than controls [34.5 (14.2) vs. 38.5 (9.9) g/L, P=0.032] (Table 1); C reactive protein level was higher in cases than controls [26.12 (21.3) vs. 6.7 (16.4) mg/L, P=0.045] (Table 1).

(3) The aortic valvular insufficiency presented more frequently in patients in the case group than the control group (92.3% vs. 47.7%, respectively; P=0.004).Heart reconstruction can be seen in Behcet'patients with cardiac involvement. The echocardiography showed the following parameters were significantly different between two groups: left ventricular end-diastolic diameter (64.85±10.96 vs. 52.55±10.13 mm, P=0.001); left ventricular end-contraction diameter [48 (15) vs. 31 (13) mm, P=0.001]; left atrial diameter [50 (17) vs. 35.85 (13) mm, P=0.003]; outflow tract of right ventricle [26 (7) vs. 27 (6) mm, P=0.045]

(4) Aortic valvular insufficiency was an independent risk factor for Behcet's disease with conduction disturbances (OR =1.157, 95% CI 1.034, 1.293, P=0.011).

Conclusions Behcet's disease is one of the unusual etiologies of atrioventricular block. The evaluation of conduction disturbance should be kept in mind when diagnosing BD's patient.

References

1. Desbois A C, Wechsler B, Cluzel P, et al.: Cardiovascular involvement in Behcet's disease.Rev Med Interne 2014; 35(2):103–111.

2. Braunwald E,Fauci A.S, Kasper D, et al.: Harrison's principles of international medicine. New York: McGraw-Hill 2001,1287.

3. Butt SU, McNeil J.: Complete heart block in a Caucasian woman with Behçet's disease: a case report. J Med Case Rep 2016;19;10:102.

4. Gao N, Han W, Ci WP,et al.: Clinical data analysis of cardiovascular involvement in Behcet's disease. Zhonghua Yi Xue Za Zhi 2016,24;96(19):1523–6.

References

Disclosure of Interest None declared