Evaluation of diastolic dysfunction and repolarization dispersion in Behcet's disease

Behcet's disease is a generalized chronic inflammatory disease characterize d by genital, ocular, and cardiovascular involvement. Recently, left ventri cular diastolic dysfunction, ventricular arrhythmia and sudden cardiac deat h have been documented in Behcet's disease. From January 1996 to May 1998, we investigated left ventricular systolic and diastolic function, valvular heart disease, ischemic heart disease and repolarization dispersion in 71 c ases, 40 men and 31 women (mean age, 36.8+/-10.3 years) with Behcet's disea se. All of the results were compared with the control group of 33 men and 2 2 women (mean age, 37.9+/-9.6 years). Exercise stress test or myocardial pe rfusion scintigraphy was performed for the documentation of ischemia. All t he patients and the controls were recorded by M-mode, 2-D and Doppler echoc ardiography. Ventricular wall thickness, valvular apparatus, left ventricul ar systolic and diastolic parameters were evaluated. Repolarization dispers ion parameters were calculated as the difference between maximal and minima l values of QT from 12-lead electrocardiogram recording at baseline, immedi ate and end of recovery from the exercise stress tests. The measured parame ters were compared with the control group by using statistical methods. In the Behcet's group of 22 patients (31%) EIA ratio was <1. In the control gr oup of five cases (10%) E/A ratio was <1 (P=0.003), In the Behcet's group i sovolumic relaxation time (IRT) and mitral deceleration time (MDT) were lon ger than the control group (P=0.002, P=0.041, respectively). A mean QT of 3 68+/-30 ms and mean QT dispersion of 73+/-14 ms in the patient group compar ed with a mean QT of 395+/-39 ms and mean QT dispersion of 38+/-12 ms in th e controls. There was no statistical difference between the mean QT values of the patient and control groups however, ventricular dispersion parameter s in the Behcet's patients were longer than in the controls (P<0.001). Ther e was also statistical significance for the QT dispersion between the Behce t's patients with and without diastolic dysfunction (P<0.01). In conclusion , the study reveals that the patients with Behcet's disease have a high inc idence of increased diastolic dysfunction and repolarization dispersion. A positive correlation may exist between diastolic dysfunction and QT dispers ion. (C) 2000 Elsevier Science Ireland Ltd. All rights reversed.