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Evaluation of Cardiac Arrhythmia Susceptibility in Pediatric Familial Mediterranean Fever Patients. JOURNAL OF CONTEMPORARY MEDICINE 2023. [DOI: 10.16899/jcm.1232293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Aim: Familial Mediterranean fever is an autoinflammatory disease characterized by attacks of inflammation. Despite treatment, there is evidence of subclinical persistence of inflammation with normal laboratory values. This study was conducted to investigate the cardiac effects of continued subclinical inflammation in children and the predisposition towards arrhythmia in familial Mediterranean fever.
Materials and Methods: Age and sex-matched familial Mediterranean fever patients and healthy controls were compared in terms of demographic, laboratory, echocardiographic and electrocardiographic data. The patients with familial Mediterranean fever were grouped according to disease severity scores and compared in terms of electrocardiographic data that could indicate arrhythmogenesis. Correlation analysis was used to examine the relationship between the electrocardiographic measurements and the clinical and laboratory data.
Results: In the comparison of the two groups, no significant difference was found in the echocardiographic measurements in terms of left ventricular systolic and diastolic functions. According to these data, QT and Tp-e intervals were significantly longer in those with familial Mediterranean fever (p=0.002, p=0.046, respectively). When the patients were classified according to the 3 separate disease severity scores, QT dispersion in the moderate-severe disease group was significantly longer than in the mild disease group (p
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Motawea KR, El-Sakka AA, Kandil OA, Ahmed N, Abdelnaem M, Zaki B, Elhalag RH, Varney J, Swed S, Nashwan AJ, Sawaf B, Seijari M, Farwati A, Battikh N, Rakab A. Relation Between Familial Mediterranean Fever and QT Markers (QTc, QTd, and QTcd): A Systematic Review and Meta-Analysis. Cureus 2022; 14:e30585. [DOI: 10.7759/cureus.30585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/22/2022] [Indexed: 11/05/2022] Open
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Nussinovitch U, Livneh A. Late ventricular potentials in familial Mediterranean fever with and without AA amyloidosis. Eur J Rheumatol 2017; 4:184-188. [PMID: 29164000 DOI: 10.5152/eurjrheum.2017.16113] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Accepted: 05/21/2017] [Indexed: 01/13/2023] Open
Abstract
Objective Familial Mediterranean fever (FMF) is an autosomal recessive disease characterized by episodic and chronic inflammation that may lead to both accelerated coronary atherosclerosis and cardiac AA amyloidosis. We hypothesized that late ventricular potentials (LPs), an established electrocardiographic susceptibility marker of ventricular arrhythmias, will be more common in FMF than in the adjusted normal population due to these two types of inflammation-associated cardiac effects. Therefore, we aimed to evaluate the occurrence of LPs in FMF patients with and without amyloidosis. Material and Methods Signal-averaged electrocardiography was performed in consecutive patients with FMF using the Frank corrected orthogonal lead system. At least 200 consecutive beats were digitally recorded and averaged, and the presence of LPs was determined according to acceptable thresholds. Results There were 54 patients with colchicine-treated FMF, of whom 14 had biopsy-proven AA amyloidosis. None of the uncomplicated FMF patients and 2 of the 14 FMF amyloidosis patients had abnormal or borderline LPs. Conclusion Based on LPs as a susceptibility marker for arrhythmia, FMF patients, including the large majority of FMF patients with amyloidosis, are seemingly not at an increased risk to develop arrhythmias.
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Affiliation(s)
- Udi Nussinovitch
- Medicine A, Rambam Health Care Campus, Haalia Hashnia, Haifa, Israel
| | - Avi Livneh
- The Heller Institute of Medical Research and Medicine F, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Cardiovascular disease in patients with autoinflammatory syndromes. Rheumatol Int 2017; 38:37-50. [DOI: 10.1007/s00296-017-3854-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Accepted: 10/13/2017] [Indexed: 12/16/2022]
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Karaman K, Arisoy A, Altunkas A, Erken E, Demirtas A, Ozturk M, Karayakali M, Sahin S, Celik A. Aortic Flow Propagation Velocity in Patients with Familial Mediterranean Fever: an Observational Study. Korean Circ J 2017; 47:483-489. [PMID: 28765740 PMCID: PMC5537150 DOI: 10.4070/kcj.2016.0400] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2016] [Revised: 02/03/2017] [Accepted: 03/11/2017] [Indexed: 11/18/2022] Open
Abstract
Background and Objectives Systemic inflammation has an important role in the initiation of atherosclerosis, which is associated with arterial stiffness (AS). Aortic flow propagation velocity (APV) is a new echocardiographic parameter of aortic stiffness. The relationship between systemic inflammation and AS has not yet been described in patients with familial Mediterranean fever (FMF). We aimed to investigate the early markers of AS in patients with FMF by measuring APV and carotid intima-media thickness (CIMT). Subjects and Methods Sixty-one FMF patients (43 women; mean age 27.3±6.7 years) in an attack-free period and 57 healthy individuals (36 women; mean age 28.8±7.1 years) were included in this study. The individuals with atherosclerotic risk factors were excluded from the study. The flow propagation velocity of the descending aorta and CIMT were measured to assess AS. Results APV was significantly lower (60.2±16.5 vs. 89.5±11.6 cm/sec, p<0.001) and CIMT was significantly higher (0.49±0.09 vs. 0.40±0.10 mm, p<0.001) in the FMF group compared to the control group. There were significant correlations between APV and mean CIMT (r=-0.424, p<0.001), erythrocyte sedimentation rate (ESR) (r=-0.198, p=0.032), and left ventricle ejection fraction (r=0.201, p=0.029). APV and the ESR were independent predictors of FMF in logistic regression analysis (OR=-0.900, 95% CI=0.865-0.936, p<0.001 and OR=-1.078, 95% CI=1.024-1.135, p=0.004, respectively). Mean CIMT and LVEF were independent factors associated with APV in linear regression analysis (β=-0.423, p<0.001 and β=0.199, p=0.017, respectively). Conclusion We demonstrated that APV was lower in FMF patients and is related to CIMT. According to our results, APV may be an independent predictor of FMF.
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Affiliation(s)
- Kayihan Karaman
- Department of Cardiology, Gaziosmanpasa University School of Medicine, Tokat, Turkey
| | - Arif Arisoy
- Department of Cardiology, Gaziosmanpasa University School of Medicine, Tokat, Turkey
| | - Aysegul Altunkas
- Department of Radiology, Gaziosmanpasa University School of Medicine, Tokat, Turkey
| | - Ertugrul Erken
- Department of Internal Medicine, Gaziosmanpasa University School of Medicine, Tokat, Turkey
| | - Ahmet Demirtas
- Department of Internal Medicine, Gaziosmanpasa University School of Medicine, Tokat, Turkey
| | - Mustafa Ozturk
- Department of Cardiology, Erzurum Territorial Training and Research Hospital, Erzurum, Turkey
| | - Metin Karayakali
- Department of Cardiology, Gaziosmanpasa University School of Medicine, Tokat, Turkey
| | - Safak Sahin
- Department of Internal Medicine, Gaziosmanpasa University School of Medicine, Tokat, Turkey
| | - Atac Celik
- Department of Cardiology, Gaziosmanpasa University School of Medicine, Tokat, Turkey
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Karaman K, Karayakali M, Erken E, Demirtaş A, Öztürk M, Altunkaş F, Arisoy A, Turan OE, Ceyhan K, Çelik A. Assessment of myocardial repolarisation parameters in patients with familial Mediterranean fever. Cardiovasc J Afr 2017; 28:154-158. [PMID: 28759086 PMCID: PMC5558142 DOI: 10.5830/cvja-2016-074] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Accepted: 07/10/2016] [Indexed: 01/13/2023] Open
Abstract
Background: Familial Mediterranean fever (FMF) is a chronic, recurrent auto-inflammatory disease characterised by self-terminating attacks of fever and sterile polyserositis. The main cause of death in auto-inflammatory diseasesis cardiovascular events. Additionally, auto-inflammatory diseases have potential effects on the myocardial repolarisation parameters, including the T-wave peak-to-end (Tp-Te) interval, cTp-Te interval (corrected Tp-Te) and the cTp-Te/ QT ratio. The aim of this study was to analyse the efficacy of myocardial repolarisation alterations in anticipation of cardiovascular risks in patients with FMF. Methods: This study included 66 patients with FMF and 58 healthy control subjects. Tp-Te and cTp-Te intervals and the cTp-Te/QT ratio were measured from the 12-lead electrocardiogram. Results: In electrocardiographic parameters, analysis of QT, QT dispersion, corrected QT (QTc) and QTc dispersion were similar between the groups. The Tp-Te and cTp-Te intervals and Tp-Te/QT and cTp-Te/QT ratios were significantly prolonged in FMF patients. Multivariate linear regression analyses indicated that erythrocyte sedimentation rate was an independent predictor of a prolonged cTp-Te interval. Conclusions: Our study revealed that when compared with control subjects, Tp-Te and cTp-Te intervals and cTp-Te/QT ratio were increased in FMF patients.
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Affiliation(s)
- Kayihan Karaman
- Department of Cardiology, Gaziosmanpasa University School of Medicine, Tokat, Turkey.
| | - Metin Karayakali
- Department of Cardiology, Gaziosmanpasa University School of Medicine, Tokat, Turkey
| | - Ertuğrul Erken
- Department of Cardiology, Gaziosmanpasa University School of Medicine, Tokat, Turkey
| | - Ahmet Demirtaş
- Department of Cardiology, Gaziosmanpasa University School of Medicine, Tokat, Turkey
| | - Mustafa Öztürk
- Department of Cardiology, Gaziosmanpasa University School of Medicine, Tokat, Turkey
| | - Fatih Altunkaş
- Department of Cardiology, Gaziosmanpasa University School of Medicine, Tokat, Turkey
| | - Arif Arisoy
- Department of Cardiology, Gaziosmanpasa University School of Medicine, Tokat, Turkey
| | - Oğuzhan Ekrem Turan
- Department of Cardiology, Gaziosmanpasa University School of Medicine, Tokat, Turkey
| | - Köksal Ceyhan
- Department of Cardiology, Gaziosmanpasa University School of Medicine, Tokat, Turkey
| | - Ataç Çelik
- Department of Cardiology, Gaziosmanpasa University School of Medicine, Tokat, Turkey
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Deteriorated Systolic Blood Pressure Recovery and Heart Rate Recovery After Graded Exercise in Children With Familial Mediterranean Fever. Arch Rheumatol 2017; 32:244-249. [PMID: 30375532 DOI: 10.5606/archrheumatol.2017.6071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Accepted: 10/28/2016] [Indexed: 11/21/2022] Open
Abstract
Objectives This study aims to investigate if cardiac involvement may occur in children with familial Mediterranean fever (FMF) without cardiovascular symptoms by using heart rate recovery (HRR) and systolic blood pressure recovery (SBPR) parameters. Patients and methods A total of 50 FMF patients (26 males, 24 females; mean age 151±33.4 month; range 60 to 216 month) and 30 healthy controls (18 males, 12 females; mean age 143±43.9 month; range 84 to 228 month) were included in the study. All patients were evaluated by echocardiography. All patients underwent a maximal graded exercise stress test. HRR and SBPR parameters were calculated. Results There was a significant decrease in HRR1 value in FMF group (p=0.03). SBPR1 and SPBR2 values were higher in FMF group compared to control group (0.96±0.12 vs 0.88±0.12 and 0.95±0.09 vs 0.91±0.11, respectively); and the high SBPR1 value was statistically significant (p=0.02). FMF presence had a negative correlation with HRR1 (r= -0.26, p=0.03) and a positive correlation with SBPR1 (r=0.29, p=0.02). There was a negative correlation of M694V homozygous mutation with HRR1 and HRR2 values (r= -0.43, p=0.004, r=-0.42, p=0.005). Conclusion Cardiac involvement may occur in FMF patients without cardiovascular symptoms. Impaired SBPR and decreased HRR response may indicate increased cardiovascular risk in these patients despite normal exercise stress test results.
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Giese A, Örnek A, Kurucay M, Kara K, Wittkowski H, Gohar F, Menge BA, Schmidt WE, Zeidler C. P wave dispersion and QT dispersion in adult Turkish migrants with familial mediterranean fever living in Germany. Int J Med Sci 2014; 11:1140-6. [PMID: 25170297 PMCID: PMC4147640 DOI: 10.7150/ijms.9444] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2014] [Accepted: 07/21/2014] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Familial Mediterranean Fever (FMF) is a hereditary autoinflammatory disease associated with subclinical inflammation, which includes atherosclerosis arising from endothelial inflammation, which in turn increases the risk of atrial or ventricular arrhythmias. Conduction abnormalities can be detected using the electrocardiographic (ECG) indices P and QT dispersion (Pdisp and QTdisp). Currently, it is unknown whether patients with FMF are more likely to have abnormalities of these ECG indices. Moreover, existing studies were conducted in countries with higher FMF prevalence. We therefore perform the first prospective study assessing Pdisp and QTdisp in adult FMF patients in Germany, where prevalence of FMF is low. METHOD Asymptomatic FMF patients (n=30) of Turkish ancestry living in Germany and age-matched healthy controls (n=37) were prospectively assessed using 12-lead ECG. RESULTS Patients and controls were comparable in gender and body mass index, and patients had higher erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and serum amyloid A (SAA) compared to controls (ESR: 23.7±14.3 vs. 16.1±13,3 mm/1(st)h, p=0.03, CRP: 0.73±0.9 vs. 0.26±0.4 g/dl, p=0.01, SAA: 3.14±4,8 vs. 0.37±0.3 mg/dl, p<0.01). No statistically significant difference between patients and controls respectively, for Pdisp (43.7±11.9 vs. 47.1±11.2ms, p=0.23), QTdisp (65.9±12.3 vs. 67.6±12.7 ms, p=0.58) or corrected QTdisp (cQTdisp: 73.9±15.0 vs. 76.0±13.3 ms, p=0.55) was found. No correlation could be found between Pdisp or QTdisp or cQTdisp and any of the biochemical markers of inflammation. CONCLUSION FMF patients living in Germany show a Pdisp and QTdisp comparable to healthy controls, with no increased risk of atrial or ventricular arrhythmias indicated.
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Affiliation(s)
- Arnd Giese
- 1. Department of Internal Medicine I, St. Josef-Hospital, Medical Centre of the Ruhr-University Bochum, Gudrunstraße 56, 44791 Bochum, Germany
- 2. Department of Internal Medicine I, Marienhospital Herne, Medical Centre of the Ruhr-University Bochum, Herne, Germany
| | - Ahmet Örnek
- 2. Department of Internal Medicine I, Marienhospital Herne, Medical Centre of the Ruhr-University Bochum, Herne, Germany
- 3. Institute for Radiologic Diagnostics, Bergmannsheil, Ruhr-University Bochum, Bochum, Germany
| | - Mustafa Kurucay
- 2. Department of Internal Medicine I, Marienhospital Herne, Medical Centre of the Ruhr-University Bochum, Herne, Germany
| | - Kaffer Kara
- 4. Department of Internal Medicine II, St. Josef-Hospital, Medical Centre of the Ruhr-University Bochum, Bochum, Germany
| | - Helmut Wittkowski
- 5. Department of Paediatric Rheumatology and Immunology, University Children's Hospital Muenster, Germany
- 6. AID-NET Autoinflammatory disorders (AID) in children: Genetics, disease mechanisms, diagnostic markers and therapeutic targets, Essen and Muenster, Germany
| | - Faekah Gohar
- 5. Department of Paediatric Rheumatology and Immunology, University Children's Hospital Muenster, Germany
- 6. AID-NET Autoinflammatory disorders (AID) in children: Genetics, disease mechanisms, diagnostic markers and therapeutic targets, Essen and Muenster, Germany
| | - Bjoern A. Menge
- 1. Department of Internal Medicine I, St. Josef-Hospital, Medical Centre of the Ruhr-University Bochum, Gudrunstraße 56, 44791 Bochum, Germany
| | - Wolfgang E. Schmidt
- 1. Department of Internal Medicine I, St. Josef-Hospital, Medical Centre of the Ruhr-University Bochum, Gudrunstraße 56, 44791 Bochum, Germany
| | - Christoph Zeidler
- 1. Department of Internal Medicine I, St. Josef-Hospital, Medical Centre of the Ruhr-University Bochum, Gudrunstraße 56, 44791 Bochum, Germany
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Kaya H, Süner A, Köroğlu S, Akçay A, Türkbeyler İH, Köleoğlu M. Heart rate variability in familial Mediterranean fever patients. Eur J Rheumatol 2014; 1:58-61. [PMID: 27708876 DOI: 10.5152/eurjrheumatol.2014.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2014] [Accepted: 03/27/2014] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE Familial Mediterranean fever (FMF) is an autosomal recessive autoimmune disease, presenting with the attacks of fever and inflammation of serous membranes. One of the leading causes of death in autoimmune rheumatologic diseases is cardiovascular events. The purpose of this study is to evaluate the effects of FMF on the autonomic nerve and cardiovascular systems by measuring the indices of heart rate variability (HRV). MATERIAL AND METHODS Thirty FMF patients and the same number of healthy volunteers were enrolled to the study. Standard deviation of all R-R intervals (SDNN), the square root of the sum of the square of the differences between successive R-R intervals (RMSSD), standard deviation of 5-minute mean values of R-R interval (SDANN), low frequency (LF), and high frequency (HF) were measured. RESULTS Time domain indices (SDNN, SDANN, and RMSSD) were: 124.67±40.79, 129.87±36.43 (p=0.605); 11.43±38.41, 11.23±38.98 (p=0.984); and 33.43±17.39, 38.17±12.8 (p=0.235) for FMF patients and controls, respectively, and similar in both groups. Frequency domain indices (HF, LF, and LF/HF) were: 290.41±290.25, 322.20±222.54 (p=0.639); 596.16±334.07, 805.80±471.00 (p=0.051); and 3.57±2.57, 3.05±1.40 (p=0.338) for FMF patients and controls, respectively, and similar in both groups. CONCLUSION The HRV parameters were similar in both groups. However, studies including larger populations and using different methods are required to clarify if autonomic dysfunction exists in patients with FMF.
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Affiliation(s)
- Hakan Kaya
- Department of Cardiology, Adıyaman University Faculty of Medicine, Adıyaman, Turkey
| | - Arif Süner
- Department of Cardiology, Adıyaman University Faculty of Medicine, Adıyaman, Turkey
| | - Sedat Köroğlu
- Department of Cardiology, Afşin State Hospital, Kahramanmaraş, Turkey
| | - Ahmet Akçay
- Department of Cardiology, Sütçü İmam University Faculty of Medicine, Kahramanmaraş, Turkey
| | | | - Murat Köleoğlu
- Department of Cardiology, Avicenna Hospital, İstanbul, Turkey
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Acar G, Yorgun H, Inci MF, Akkoyun M, Bakan B, Nacar AB, Dirnak I, Cetin GY, Bozoglan O. Evaluation of Tp-e interval and Tp-e/QT ratio in patients with ankylosing spondylitis. Mod Rheumatol 2013. [PMID: 23579501 DOI: 10.1007/s10165-013-0881-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2013] [Accepted: 03/30/2013] [Indexed: 12/20/2022]
Abstract
OBJECTIVES: Ankylosing spondylitis (AS) is a chronic multi-systemic inflammatory rheumatic disorder. Several studies have suggested that the interval from the peak to the end of the electrocardiographic T wave (Tp-e) may correspond to the transmural dispersion of repolarization and that increased Tp-e interval and Tp-e/QT ratio are associated with malignant ventricular arrhythmias. The aim of this study was to evaluate ventricular repolarization by using Tp-e interval and Tp-e/QT ratio in patients with AS, and to assess the relation with inflammation. METHODS: Sixty-two patients with AS and 50 controls were included. Tp-e interval and Tp-e/QT ratio were measured from a 12-lead electrocardiogram, and the Tp-e interval corrected for heart rate. The plasma level of high sensitive C-reactive protein (hsCRP) was measured. These parameters were compared between groups. RESULTS: In electrocardiographic parameters analysis, QT dispersion (QTd) and corrected QTd were significantly increased in AS patients compared to the controls (31.7 ± 9.6 vs 28.2 ± 7.4 and 35.8 ± 11.5 vs 30.6 ± 7.9 ms, P = 0.03 and P = 0.007, respectively). cTp-e interval and Tp-e/QT ratio were also significantly higher in AS patients (92.1 ± 10.2 vs 75.8 ± 8.4 and 0.22 ± 0.02 vs 0.19 ± 0.02 ms, all P values <0.001). cTp-e interval and Tp-e/QT ratio were significantly correlated with hsCRP (r = 0.63, P < 0.001 and r = 0.49, P < 0.001, respectively). CONCLUSIONS: Our study revealed that Tp-e interval and Tp-e/QT ratio were increased in AS patients. These electrocardiographic ventricular repolarization indexes were significantly correlated with the plasma level of hsCRP.
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Affiliation(s)
- Gurkan Acar
- Kardiyoloji Anabilim Dali, Tıp Fakultesi, Kahramanmaraş Sutcu Imam Universitesi, Kahramanmaras, 46100, Turkey,
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Arslan D, Oran B, Yazılıtas F, Peru H, Cimen D, Vatansev H. P-wave duration and dispersion in children with uncomplicated familial Mediterranean fever. Mod Rheumatol 2012; 23:1166-71. [PMID: 23274952 DOI: 10.1007/s10165-012-0815-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2012] [Accepted: 12/05/2012] [Indexed: 11/27/2022]
Abstract
OBJECTIVES This was a prospective controlled study to determine the P-wave duration (Pdu) and P-wave dispersion (Pd) in patients with familial Mediterranean fever (FMF). METHODS The study group consisted of 26 children with uncomplicated FMF and 25 age- and sex-matched healthy controls. We performed electrocardiography (ECG) with Doppler echocardiography on patients and controls. All participants underwent 12-lead electrocardiography under strict standards. Pdu and Pd were computed from a randomly selected beat and from an averaged beat constructed from 12 beats, included in a 10-s ECG. RESULTS The left ventricle (LV) dimensions, LV ejection fraction (LVEF), and LV fractional shortening (LVFS) values, left atrium dimension, and aortic dimension were in normal range in both groups. There were significant differences between the groups regarding LV-isovolumic relaxation time (IRT), LV-isovolumic contraction time (ICT), right ventricle (RV)-ICT, RV-IRT, and Pd (all p < 0.0001). However, highly significant positive correlation was detected between LV-ICT, LV-IRT, RV-ICT, RV-IVT, C-reactive protein (CRP), and Pd (r = 0.505, p < 0.0001; r = 0.483, p < 0.0001; r = 0.433, p = 0.001; r = 0.421, p = 0.001; r = 0.452, p = 0.001; r = 0.478, p < 0.0001, respectively). CONCLUSIONS Uncomplicated FMF children who are continuously treated with colchicine and do not develop amyloidosis have abnormal atrial dispersion and therefore seemingly have an increased electrocardiographic risk of atrial fibrillation.
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Affiliation(s)
- Derya Arslan
- Department of Pediatric Cardiology, Selcuk University Faculty of Medicine, 42080, Konya, Turkey,
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Nussinovitch U, Livneh A, Volovitz B, Nussinovitch M, Ben-Zvi I, Lidar M, Nussinovitch N. Normal QT dispersion in colchicine-resistant familial Mediterranean fever (FMF). Clin Rheumatol 2012; 31:1093-6. [DOI: 10.1007/s10067-012-1982-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2011] [Revised: 03/18/2012] [Accepted: 03/26/2012] [Indexed: 11/29/2022]
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Nussinovitch U, Kaminer K, Nussinovitch M, Volovitz B, Lidar M, Nussinovitch N, Livneh A. QT interval variability in familial Mediterranean fever: a study in colchicine-responsive and colchicine-resistant patients. Clin Rheumatol 2012; 31:795-9. [PMID: 22271228 DOI: 10.1007/s10067-011-1926-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2011] [Revised: 12/06/2011] [Accepted: 12/20/2011] [Indexed: 02/02/2023]
Abstract
The association between familial Mediterranean fever (FMF), early atherosclerosis, and electrocardiographic markers for arrhythmias remains controversial. There are conflicting results as to the occurrence of high QT dispersion in FMF. The aim of the present study was to further investigate repolarization dynamics and other repolarization-associated pro-arrhythmogenic markers in FMF patients. To explore repolarization in FMF, patients who responded well to colchicine and patients who had not responded to colchicine, yet were amyloidosis-free, were included. We aimed to evaluate whether increased inflammatory burden, a characteristic of non-responsive patients, was specifically associated with abnormal repolarization. Included in the study were 53 FMF patients (27 colchicine non-responders) and 53 age- and sex-matched control subjects. Electrocardiograms were performed under strict standards. QT variability parameters were computed with custom-made computer software. No significant difference in any of the QT dynamic parameters was found in either FMF group compared with the healthy controls. Mean values of QT variability index, regardless of colchicine response, were similar to previously published results for healthy persons. In conclusion, patients with FMF who are continuously treated with colchicine and have not developed amyloidosis, regardless of their clinical response, have normal QT variability parameters, indicating normal repolarization dynamics and suggesting no increased risk of repolarization-associated cardiac arrhythmias.
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Affiliation(s)
- Udi Nussinovitch
- Israel Naval Medical Institute, IDF Medical Corps, Haifa, Israel 31080.
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Nussinovitch U, Livneh A, Nussinovitch M, Volovitz B, Ben-Zvi I, Lidar M, Nussinovitch N. P-wave dispersion in systemic AA amyloidosis of familial Mediterranean fever. Clin Rheumatol 2011; 30:1295-8. [DOI: 10.1007/s10067-011-1745-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2010] [Revised: 02/26/2011] [Accepted: 03/25/2011] [Indexed: 01/12/2023]
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Nussinovitch U, Nussinovitch N, Nussinovitch M, Volovitz B, Feld O, Ben-Zvi I, Livneh A. QT dispersion in amyloidosis due to familial Mediterranean fever. Rheumatol Int 2011; 32:1945-8. [DOI: 10.1007/s00296-011-1896-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2010] [Accepted: 03/13/2011] [Indexed: 02/05/2023]
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Assessment of heart rate recovery index in patients with familial Mediterranean fever. Rheumatol Int 2010; 31:121-5. [PMID: 20652273 DOI: 10.1007/s00296-010-1550-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2010] [Accepted: 07/11/2010] [Indexed: 10/19/2022]
Abstract
Heart rate recovery after exercise is a function of vagal reactivation, and its impairment is an independent prognostic indicator for cardiovascular and all-cause mortality. The aim of our study was to evaluate heart rate recovery in patients with familial Mediterranean fever (FMF). The study population included 38 patients with FMF (14 men; mean age, 36.2 ± 12.1 years, and mean disease duration = 11.3 ± 6.5 years) and 35 healthy control subjects (12 men; mean age = 34.1 ± 9.9 years). Basal electrocardiography, echocardiography, and treadmill exercise testing were performed in all patients and control participants. The heart rate recovery index was defined as the reduction in the heart rate from the rate at peak exercise to the rate 1st-minute (HRR(1)), 2nd-minute (HRR(2)), 3rd-minute (HRR(3)), and 5th-minute (HRR(5)) after the cessation of exercise stress testing. There are significant differences in HRR(1) and HRR(2) indices between patients with FMF and control group (26.4 ± 7.4 vs. 35.0 ± 8.0; P = 0.001 and 47.3 ± 11.8 vs. 54.8 ± 10.3; P = 0.002, respectively). Similarly, HRR(3) and HRR(5) indices of the recovery period were lower in patients with FMF, when compared with indices in the control group (56.0 ± 14.0 vs. 63.7 ± 11.2; P = 0.01 and 64.1 ± 14.7 vs. 71.5 ± 12.7; P = 0.02, respectively). There were also remarkably positive correlations between the disease duration and HRR(1) (r = 0.31, P = 0.02), and HRR(2) (r = 0.26, P = 0.04). The heart rate recovery index impaired in patients with FMF compared to control subjects. When the prognostic significance of the heart rate recovery index is considered, a useful, simple, and noninvasive test may be clinically helpful in the recognition of high-risk patients with FMF.
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Nussinovitch N, Livneh A, Katz K, Langevitz P, Feld O, Nussinovitch M, Volovitz B, Lidar M, Nussinovitch U. QT dispersion in uncomplicated familial Mediterranean fever. Clin Rheumatol 2010; 29:1353-6. [DOI: 10.1007/s10067-010-1434-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2009] [Revised: 02/26/2010] [Accepted: 03/11/2010] [Indexed: 12/11/2022]
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