Pulmonary hypertension in Behçet’s disease: echocardiographic screening and multidisciplinary approach

BACKGROUND/AIM: Little is known about the prevalence and causes of pulmonary hypertension (PH) in Behçet’s disease (BD). This study was conducted to determine the prevalence and causes of PH in BD. MATERIALS AND METHODS: In this descriptive study, we screened 154 patients with BD for PH using transthoracic echocardiography between February 2017 and October 2017. An estimated systolic pulmonary arterial pressure (sPAP ≥ 40 mmHg) was used as the cut-off value to define PH. Patients with BD were categorized into 5 groups according to organ involvement including mucocutaneous/articular, ocular, vascular, gastrointestinal, and neurologic involvement. Additional laboratory and imaging results were obtained from hospital file records to determine the causes of PH. RESULTS: PH was detected in 17 (11%) patients. Nine (52.9%) of these patients had group II PH (due to left heart disease), 4 (23.5%) had IV PH (due to pulmonary arterial involvement), and 1 had III PH (due to chronic obstructive lung disease). The frequency of PH was higher in BD patients with vascular involvement than those without (52.9% vs 28.5%; p = 0.04). Among 10 patients with pulmonary artery involvement (PAI) 4 (40%) had PH. Although the vascular BD group had the highest rate of PH, we observed no statistically significant difference in the frequency of PH between the predefined BD subgroups. CONCLUSIONS: PH is not rare in patients with BD. The majority of BD patients with PH are in group II or IV PH. Patients with vascular involvement carry a higher risk for the development of PH. Monitoring BD patients with PAI should be considered for the development of group IV PH.