Delayed time of atrial conduction in children with Familial Mediterranean Fever

Fatih BATTAL; Fatih BİNNETOGLU; Hakan AYLANC; Şule YILDIRIM; Nazan KAYMAZ; Öztürk ÖZDEMİR

doi:10.22391/fppc.753146

Araştırma Makalesi

Ailevi Akdeniz Ateşi tanılı çocuklarda gecikmiş atrial ileti zamanı

Yıl 2021, Cilt 6, Sayı 2, 92 - 97, 05.05.2021

Fatih BATTAL Fatih BİNNETOGLU Hakan AYLANC Şule YILDIRIM Nazan KAYMAZ Öztürk ÖZDEMİR

https://doi.org/10.22391/fppc.753146

Cited By: 1

Öz

Giriş: FMF seröz zarların ağrılı inflamasyonu ile karakterize tekrarlayan ateşin eşlik ettiği genetik bir hastalıktır. Çoğunlukla Ermeniler, Türkler, Araplar ve Yahudiler etkilenir. Ailesel Akdeniz Ateşinde uzun süreli inflamasyon atriyal iletim süresinin bozulmasına ve atriyal fibrozise yol açabilir. Bu çalışmada Ailesel Akdeniz Ateş olan çocuklarda atriyal iletim süresini değerlendirmeyi amaçladık.

Yöntem: Çalışmaya Ekim 2015-Ekim 2016 tarihleri arasında Çocuk Sağlığı ve Hastalıkları Polikliniğimizde 36 FMF (17 erkek / 19 kız) tanılı hasta ile 20 kontrol (7 erkek / 13 kız) olgusu dahil edildi. Doku Doppler Ekokardiyografi ve interatriyal elektromekanik gecikme ölçümleri yapıldı. P dalga dispersiyonu (pdisp), 12 derivasyonlu elektrokardiyogramdan hesaplandı.

Bulgular: FMF hastalarında inter-atriyal (Lateral PA– Trikuspid PA) ve intra-left (Lateral PA-Septal PA) atriyal elektromekanik gecikme anlamlı olarak daha uzundu (P <0,001). (PA: yüzey elektrokardiyogramında P dalgasının başlangıcı ile Doku Doppler geç diyastolik dalga A'nın başlangıcı arasındaki zaman aralığı). Ayrıca FMF hastalarında P dalga dispersiyonu (Pdisp) anlamlı olarak daha yüksekti ( p =0,002).

Sonuç: Bu çalışma FMF'li çocuklarda atriyal elektromekanik gecikme ve Pdisp’'nun uzadığını göstermektedir. FMF teşhisi ile takip edilen çocukların atrial ileti sürelerinin ölçülmesini öneriyoruz.

Anahtar Kelimeler

Çocuk, Ailesel Akdeniz Ateşi, Elektrokardiyografi, Elektromekanik gecikme

Kaynakça

1. McDermott MF, Aksentijevich I, Galon J, McDermott EM, Ogunkolade BW, Centola M,.et al. Germ line mutations in the extracellular domains of the 55 kDa TNF receptor,TNFR1,define a family of dominantly inherited autoinflammatory syndromes. Cell. 1999;97 (1):133–4. https://doi.org/10.1016/s0092-8674(00)80721-7
2. Brydges S, Kastner DL. The systemic autoinflammatory diseases: inborn errors of the innate immune system. Curr Top Microbiol Immunol. 2006;305:127–60. https://doi.org/10.1007/3-540-29714-6_7
3. Manukyan G, Aminov R. Update on Pyrin Functions and Mechanisms of Familial Mediterranean Fever. Front Microbiol. 2006;31(7):456. https://doi.org/10.3389/fmicb.2016.00456
4. The French FMF Consortium. A candidate gene for familial mediterranean fever. Nat Genet. 1997;17(1):25–31. https://doi.org/10.1038/ng0997-25
5. The International FMF Consortium. Ancient missense mutations in a new member of the RoRet gene family are likely to cause familial Mediterranean fever. The International FMF Consortium. Cell 1997;90 (4):797–807. https://doi.org/10.1016/s0092-8674(00)80539-5
6. Soriano A, Manna R. Familial Mediterranean fever: New Phenotypes. Autoimmun Rev 2002;12(1):31–7. https://doi.org/10.1016/j.autrev.2012.07.019
7. Canpolat U, Dural M, Aytemir K, Akdoğan A, Kaya EB, Sahiner Let al. Evaluation of various cardiac autonomic indices in patients with familial Mediterranean fever on colchicine treatment. Auton Neurosci 2012;(1)167:70-4. https://doi.org/10.1016/j.autneu.2011.11.001
8. Gale A, Levin ME. Pericarditis And Auricular Fibrillation. Occurrence in Familial Mediterranean Fever.Arch Intern Med 1963;112(2) 234-41. https://doi.org/10.1001/archinte.1963.03860020132018
9. Koca B, Kasapçopur O, Bakari S, Sönmez E, Oztunç F, Eroğlu AG et al. QT dispersion and cardiac involvement in children with Familial Mediterranean fever.Cardiol Young 2012;22(4):404-9. https://doi.org/10.1017/s1047951111001867
10. Daubert JC, Pavin D, Jauvert G, Mabo P. Intra and interatrial conduction delay: implications for cardiac pacing. Pacing Clin Electrophysiol 2004;27:(4):507-5. https://doi.org/10.1111/j.1540-8159.2004.00473.x
11. Cui QQ, Zhang W, Wang H, Sun X, Wang R, Yang HY et al. Assessment of atrial electromechanical coupling and influential factors in nonrheumatic paroxysmal atrial fibrillation. Clin Cardiol 2008;31(2):74-8. https://doi.org/10.1002/clc.20162
12. Omi W, Nagai H, Takamura M, Okura S, Okajima M, Furusho H et al. Doppler tissue analysis of atrial electromechanical coupling in paroxysmal atrial fibrillation. J Am Soc Echocardiogr 2005;18(1):39-4. https://doi.org/10.1016/j.echo.2004.08.029
13. Acar G, Akcay A, Sayarlioglu M, Sokmen A, Sokmen G, Koroglu S et al. Assessment of atrial conduction time in patients with familial Mediterranean fever. Pacing Clin Electrophysiol 2009;32(3):308-13. https://doi.org/10.1111/j.1540-8159.2008.02237.x
14. Livneh A, Langevitz P, Zemer D, Zaks N, Kees S, Lidar T et al. Criteria for the diagnosis of familial Mediterranean fever. Arthritis Rheum 1997;40(10):1879-5. https://doi.org/10.1002/art.1780401023
15. Deniz A, Sahiner L, Aytemir K, Kaya B, Kabakci G, Tokgozoglu L, et al. Tissue Doppler echocardiography can be a useful technique to evaluate atrial conduction time. Cardiol J 2012;19(5):487–3. https://doi.org/10.5603/cj.2012.0089
16. Ozer N, Yavuz B, Can I, Atalar E, Aksoyek S, Ovunç K, et al. Doppler tissue evaluation of intra-atrial and interatrial electromechanical delay and comparison with P-wave dispersion in patients with mitral stenosis. J Am Soc Echocardiogr 2005;18(9):945–8. https://doi.org/10.1016/j.echo.2005.01.015
17. Waggoner AD, Adyanthaya AV, Quinones MA, Alexander JK. Left atrial enlargement. Echocardiographic assessment of electrocardiographic criteria. Circulation 1976;54:553–7. https://doi.org/10.1161/01.cir.54.4.553
18. Dilaveris PE, Gialafos EJ, Sideris SK, Theopistou AM, Andrikopoulos GK, Kyriakidis M, et al. Simple electrocardiographic markers for the prediction of paroxysmal idiopathic atrial fibrillation. Am Heart J 1998;135(5):733–8. https://doi.org/10.1016/s0002-8703(98)70030-4
19. Boos CJ, Anderson RA, Lip GYH. Is atrial fibrillation an inflammatory disorder? Eur Heart J 2006;27(2):136–39. https://doi.org/10.1093/eurheartj/ehi645
20. Yildiz A, Ucmak D, Oylumlu M, Akkurt MZ, Yuksel M, Akil MA et al. Assessment of Atrial Electromechanical Delay and P‐Wave Dispersion in Patients with Psoriasis Echocardiography. 2014;31(9):1071-6 https://doi.org/10.1111/echo.12530
21. Ozdemir O, Agras PI, Aydın Y, Abacı A, Hızlı S, Akkuş HI, et al. Assessment of cardiac functions using tissue Doppler imaging in children with familial Mediterranean fever. Cardiol Young 2012;22(2):188-3. https://doi.org/10.1017/s1047951111001168
22. Yılmaz O, Ceylan O, Orün UA, Ozgur S, Karademir S, Doğan V, et al. Assessment of left ventricular functions with tissue Doppler, strain and strain rate echocardiography in children with juvenile idiopathic arthritis: An observational study. Anatol J Cardiol 2012; 12: 339-46 https://doi.org/10.5152/akd.2012.098
23. Alsarah A, Alsara O, Laird-Fick HS. Cardiac manifestations of Familial Mediterranean fever. Avicenna J Med 2017;7(4):158-3. https://dx.doi.org/10.4103%2Fajm.AJM_78_17
24. 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 2013;23(6):1166-1. https://doi.org/10.1007/s10165-012-0815-6
25. Rexhepaj N, Bajraktari G, Berisha I, Beqiri A, Shatri F, Hima F, et al. Left and right ventricular diastolic functions in patients with rheumatoid arthritis without clinically evident cardiovascular disease. Int J Clin Pract 2006;60(6):683-8. https://doi.org/10.1111/j.1368-5031.2006.00746.x
26. Ceylan Ö, Özgür S, Örün UA, Doğan V, Yılmaz O, Keskin M, et al. Assessment of left ventricular functions with tissue Doppler, strain, and strain rate echocardiography in patients with familial Mediterranean fever. Anatol J Cardiol 2015;15(8):663-8. https://doi.org/10.5152/akd.2014.5544

Delayed time of atrial conduction in children with Familial Mediterranean Fever

Yıl 2021, Cilt 6, Sayı 2, 92 - 97, 05.05.2021

Fatih BATTAL Fatih BİNNETOGLU Hakan AYLANC Şule YILDIRIM Nazan KAYMAZ Öztürk ÖZDEMİR

https://doi.org/10.22391/fppc.753146

Cited By: 1

Öz

Introduction: Familial Mediterranean Fever (FMF) is a disease with recurrent fever, characterized by painful, noninfectious inflammation of the serous membranes. It mostly affects Armenians, Turks, Arabs and Jews. Prolonged inflammation in FMF may lead to atrial fibrosis which can cause the deterioration of atrial conduction time and refractory periods of atrial myocardium.

In the present study we aimed to assess atrial conduction time in children with FMF.

Methods: The study included 36, children diagnosed with FMF(17 males/19 females, 13 (7-15) years) and 20 control(7 males/13 females, 11 (9-16) years) cases in our Pediatric Outpatient Clinic between October 2015 and October 2016. Tissue Doppler Echocardiography (TDE) measurements of intra-and interatrial electromechanical delay were done. P wave dispersion (Pdisp) was calculated from the 12-lead electrocardiogram.

Results: Inter-atrial (Lateral PA– Tricuspid PA) and Intra-left (Lateral PA-Septal PA) atrial electromechanical delay were significantly longer in FMF patients (P<0.001,respectively). (PA: the time range between the beginning of the P wave in the surface electrocardiogram and the beginning of the tissue Doppler late diastolic wave A). Also, P-wave dispersion (Pdisp) were significantly higher in FMF patients

( p= 0.002).

Conclusions: This study shows that atrial electromechanical delay and Pdisp are prolonged in children with FMF. We recommend that atrial conduction time be measured for children diagnosed with FMF.

Anahtar Kelimeler

Child, Familial Mediterranean Fever, Electrocardiography, Electromechanical delay

Kaynakça

1. McDermott MF, Aksentijevich I, Galon J, McDermott EM, Ogunkolade BW, Centola M,.et al. Germ line mutations in the extracellular domains of the 55 kDa TNF receptor,TNFR1,define a family of dominantly inherited autoinflammatory syndromes. Cell. 1999;97 (1):133–4. https://doi.org/10.1016/s0092-8674(00)80721-7
2. Brydges S, Kastner DL. The systemic autoinflammatory diseases: inborn errors of the innate immune system. Curr Top Microbiol Immunol. 2006;305:127–60. https://doi.org/10.1007/3-540-29714-6_7
3. Manukyan G, Aminov R. Update on Pyrin Functions and Mechanisms of Familial Mediterranean Fever. Front Microbiol. 2006;31(7):456. https://doi.org/10.3389/fmicb.2016.00456
4. The French FMF Consortium. A candidate gene for familial mediterranean fever. Nat Genet. 1997;17(1):25–31. https://doi.org/10.1038/ng0997-25
5. The International FMF Consortium. Ancient missense mutations in a new member of the RoRet gene family are likely to cause familial Mediterranean fever. The International FMF Consortium. Cell 1997;90 (4):797–807. https://doi.org/10.1016/s0092-8674(00)80539-5
6. Soriano A, Manna R. Familial Mediterranean fever: New Phenotypes. Autoimmun Rev 2002;12(1):31–7. https://doi.org/10.1016/j.autrev.2012.07.019
7. Canpolat U, Dural M, Aytemir K, Akdoğan A, Kaya EB, Sahiner Let al. Evaluation of various cardiac autonomic indices in patients with familial Mediterranean fever on colchicine treatment. Auton Neurosci 2012;(1)167:70-4. https://doi.org/10.1016/j.autneu.2011.11.001
8. Gale A, Levin ME. Pericarditis And Auricular Fibrillation. Occurrence in Familial Mediterranean Fever.Arch Intern Med 1963;112(2) 234-41. https://doi.org/10.1001/archinte.1963.03860020132018
9. Koca B, Kasapçopur O, Bakari S, Sönmez E, Oztunç F, Eroğlu AG et al. QT dispersion and cardiac involvement in children with Familial Mediterranean fever.Cardiol Young 2012;22(4):404-9. https://doi.org/10.1017/s1047951111001867
10. Daubert JC, Pavin D, Jauvert G, Mabo P. Intra and interatrial conduction delay: implications for cardiac pacing. Pacing Clin Electrophysiol 2004;27:(4):507-5. https://doi.org/10.1111/j.1540-8159.2004.00473.x
11. Cui QQ, Zhang W, Wang H, Sun X, Wang R, Yang HY et al. Assessment of atrial electromechanical coupling and influential factors in nonrheumatic paroxysmal atrial fibrillation. Clin Cardiol 2008;31(2):74-8. https://doi.org/10.1002/clc.20162
12. Omi W, Nagai H, Takamura M, Okura S, Okajima M, Furusho H et al. Doppler tissue analysis of atrial electromechanical coupling in paroxysmal atrial fibrillation. J Am Soc Echocardiogr 2005;18(1):39-4. https://doi.org/10.1016/j.echo.2004.08.029
13. Acar G, Akcay A, Sayarlioglu M, Sokmen A, Sokmen G, Koroglu S et al. Assessment of atrial conduction time in patients with familial Mediterranean fever. Pacing Clin Electrophysiol 2009;32(3):308-13. https://doi.org/10.1111/j.1540-8159.2008.02237.x
14. Livneh A, Langevitz P, Zemer D, Zaks N, Kees S, Lidar T et al. Criteria for the diagnosis of familial Mediterranean fever. Arthritis Rheum 1997;40(10):1879-5. https://doi.org/10.1002/art.1780401023
15. Deniz A, Sahiner L, Aytemir K, Kaya B, Kabakci G, Tokgozoglu L, et al. Tissue Doppler echocardiography can be a useful technique to evaluate atrial conduction time. Cardiol J 2012;19(5):487–3. https://doi.org/10.5603/cj.2012.0089
16. Ozer N, Yavuz B, Can I, Atalar E, Aksoyek S, Ovunç K, et al. Doppler tissue evaluation of intra-atrial and interatrial electromechanical delay and comparison with P-wave dispersion in patients with mitral stenosis. J Am Soc Echocardiogr 2005;18(9):945–8. https://doi.org/10.1016/j.echo.2005.01.015
17. Waggoner AD, Adyanthaya AV, Quinones MA, Alexander JK. Left atrial enlargement. Echocardiographic assessment of electrocardiographic criteria. Circulation 1976;54:553–7. https://doi.org/10.1161/01.cir.54.4.553
18. Dilaveris PE, Gialafos EJ, Sideris SK, Theopistou AM, Andrikopoulos GK, Kyriakidis M, et al. Simple electrocardiographic markers for the prediction of paroxysmal idiopathic atrial fibrillation. Am Heart J 1998;135(5):733–8. https://doi.org/10.1016/s0002-8703(98)70030-4
19. Boos CJ, Anderson RA, Lip GYH. Is atrial fibrillation an inflammatory disorder? Eur Heart J 2006;27(2):136–39. https://doi.org/10.1093/eurheartj/ehi645
20. Yildiz A, Ucmak D, Oylumlu M, Akkurt MZ, Yuksel M, Akil MA et al. Assessment of Atrial Electromechanical Delay and P‐Wave Dispersion in Patients with Psoriasis Echocardiography. 2014;31(9):1071-6 https://doi.org/10.1111/echo.12530
21. Ozdemir O, Agras PI, Aydın Y, Abacı A, Hızlı S, Akkuş HI, et al. Assessment of cardiac functions using tissue Doppler imaging in children with familial Mediterranean fever. Cardiol Young 2012;22(2):188-3. https://doi.org/10.1017/s1047951111001168
22. Yılmaz O, Ceylan O, Orün UA, Ozgur S, Karademir S, Doğan V, et al. Assessment of left ventricular functions with tissue Doppler, strain and strain rate echocardiography in children with juvenile idiopathic arthritis: An observational study. Anatol J Cardiol 2012; 12: 339-46 https://doi.org/10.5152/akd.2012.098
23. Alsarah A, Alsara O, Laird-Fick HS. Cardiac manifestations of Familial Mediterranean fever. Avicenna J Med 2017;7(4):158-3. https://dx.doi.org/10.4103%2Fajm.AJM_78_17
24. 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 2013;23(6):1166-1. https://doi.org/10.1007/s10165-012-0815-6
25. Rexhepaj N, Bajraktari G, Berisha I, Beqiri A, Shatri F, Hima F, et al. Left and right ventricular diastolic functions in patients with rheumatoid arthritis without clinically evident cardiovascular disease. Int J Clin Pract 2006;60(6):683-8. https://doi.org/10.1111/j.1368-5031.2006.00746.x
26. Ceylan Ö, Özgür S, Örün UA, Doğan V, Yılmaz O, Keskin M, et al. Assessment of left ventricular functions with tissue Doppler, strain, and strain rate echocardiography in patients with familial Mediterranean fever. Anatol J Cardiol 2015;15(8):663-8. https://doi.org/10.5152/akd.2014.5544

Ayrıntılar

Birincil Dil	İngilizce
Konular	Pediatri
Yayınlanma Tarihi	Jun 2021
Bölüm	Araştırma Makalesi (Original Article)
Yazarlar	Fatih BATTAL> (Sorumlu Yazar) Department of Pediatrics, Faculty of Medicine, Canakkale Onsekiz Mart University, Canakkale 0000-0001-9040-7880 Türkiye Fatih BİNNETOGLU Bu kişi benim Department of Pediatric Cardiology, Faculty of Medicine, Canakkale Onsekiz Mart University, Canakkale 0000-0001-6304-1350 Türkiye Hakan AYLANC> Department of Pediatrics, Faculty of Medicine, Canakkale Onsekiz Mart University, Canakkale 0000-0002-8907-3809 Türkiye Şule YILDIRIM> Department of Pediatrics, Faculty of Medicine, Canakkale Onsekiz Mart University, Canakkale 0000-0001-5020-8705 Türkiye Nazan KAYMAZ> Department of Pediatrics, Faculty of Medicine, Canakkale Onsekiz Mart University, Canakkale 0000-0002-3962-4799 Türkiye Öztürk ÖZDEMİR> Department of Medical Genetics, Faculty of Medicine, Canakkale Onsekiz Mart University, Canakkale 0000-0003-1057-3235 Türkiye
Destekleyen Kurum	Yok.
Teşekkür	The authors thank our 10-year-old patient, Firdevs, who schematized the pathways of the heart (Figure-3).
Yayımlanma Tarihi	5 Mayıs 2021
Başvuru Tarihi	15 Haziran 2020
Kabul Tarihi	24 Şubat 2021
Yayınlandığı Sayı	Yıl 2021, Cilt 6, Sayı 2

Kaynak Göster

Bibtex	@araştırma makalesi { fppc753146, journal = {Family Practice and Palliative Care}, issn = {2458-8865}, eissn = {2459-1505}, address = {}, publisher = {Yusuf Haydar ERTEKİN}, year = {2021}, volume = {6}, number = {2}, pages = {92 - 97}, doi = {10.22391/fppc.753146}, title = {Delayed time of atrial conduction in children with Familial Mediterranean Fever}, key = {cite}, author = {Battal, Fatih and Binnetoglu, Fatih and Aylanc, Hakan and Yıldırım, Şule and Kaymaz, Nazan and Özdemir, Öztürk} }
APA	Battal, F. , Binnetoglu, F. , Aylanc, H. , Yıldırım, Ş. , Kaymaz, N. & Özdemir, Ö. (2021). Delayed time of atrial conduction in children with Familial Mediterranean Fever . Family Practice and Palliative Care , 6 (2) , 92-97 . DOI: 10.22391/fppc.753146
MLA	Battal, F. , Binnetoglu, F. , Aylanc, H. , Yıldırım, Ş. , Kaymaz, N. , Özdemir, Ö. "Delayed time of atrial conduction in children with Familial Mediterranean Fever" . Family Practice and Palliative Care 6 (2021 ): 92-97 <http://www.fppc.com.tr/tr/pub/issue/62141/753146>
Chicago	Battal, F. , Binnetoglu, F. , Aylanc, H. , Yıldırım, Ş. , Kaymaz, N. , Özdemir, Ö. "Delayed time of atrial conduction in children with Familial Mediterranean Fever". Family Practice and Palliative Care 6 (2021 ): 92-97
RIS	TY - JOUR T1 - Delayed time of atrial conduction in children with Familial Mediterranean Fever AU - Fatih Battal , Fatih Binnetoglu , Hakan Aylanc , Şule Yıldırım , Nazan Kaymaz , Öztürk Özdemir Y1 - 2021 PY - 2021 N1 - doi: 10.22391/fppc.753146 DO - 10.22391/fppc.753146 T2 - Family Practice and Palliative Care JF - Journal JO - JOR SP - 92 EP - 97 VL - 6 IS - 2 SN - 2458-8865-2459-1505 M3 - doi: 10.22391/fppc.753146 UR - https://doi.org/10.22391/fppc.753146 Y2 - 2021 ER -
EndNote	%0 Family Practice and Palliative Care Delayed time of atrial conduction in children with Familial Mediterranean Fever %A Fatih Battal , Fatih Binnetoglu , Hakan Aylanc , Şule Yıldırım , Nazan Kaymaz , Öztürk Özdemir %T Delayed time of atrial conduction in children with Familial Mediterranean Fever %D 2021 %J Family Practice and Palliative Care %P 2458-8865-2459-1505 %V 6 %N 2 %R doi: 10.22391/fppc.753146 %U 10.22391/fppc.753146
ISNAD	Battal, Fatih , Binnetoglu, Fatih , Aylanc, Hakan , Yıldırım, Şule , Kaymaz, Nazan , Özdemir, Öztürk . "Delayed time of atrial conduction in children with Familial Mediterranean Fever". Family Practice and Palliative Care 6 / 2 (Mayıs 2021): 92-97 . https://doi.org/10.22391/fppc.753146
AMA	Battal F. , Binnetoglu F. , Aylanc H. , Yıldırım Ş. , Kaymaz N. , Özdemir Ö. Delayed time of atrial conduction in children with Familial Mediterranean Fever. Fam Pract Palliat Care. 2021; 6(2): 92-97.
Vancouver	Battal F. , Binnetoglu F. , Aylanc H. , Yıldırım Ş. , Kaymaz N. , Özdemir Ö. Delayed time of atrial conduction in children with Familial Mediterranean Fever. Family Practice and Palliative Care. 2021; 6(2): 92-97.
IEEE	F. Battal , F. Binnetoglu , H. Aylanc , Ş. Yıldırım , N. Kaymaz ve Ö. Özdemir , "Delayed time of atrial conduction in children with Familial Mediterranean Fever", Family Practice and Palliative Care, c. 6, sayı. 2, ss. 92-97, May. 2021, doi:10.22391/fppc.753146

Family Practice and Palliative Care

Ailevi Akdeniz Ateşi tanılı çocuklarda gecikmiş atrial ileti zamanı

Öz

Anahtar Kelimeler

Kaynakça

Delayed time of atrial conduction in children with Familial Mediterranean Fever

Öz

Anahtar Kelimeler

Kaynakça

Ayrıntılar

Kaynak Göster

Cited By

ÇOCUKLUKTA AİLEVİ AKDENİZ ATEŞİ HASTALARINDA TANI GECİKMESİNİ ETKİLEYEN FAKTÖRLER

Kırıkkale Üniversitesi Tıp Fakültesi Dergisi

Elif ÇELİKEL

https://doi.org/10.24938/kutfd.933866

AİLE HEKİMLİĞİ ve PALYATİF BAKIM ISSN 2458-8865 E-ISSN 2459-1505

ANA SAYFA