Araştırma Makalesi
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Ailevi Akdeniz Ateşi tanılı çocuklarda gecikmiş atrial ileti zamanı

Yıl 2021, Cilt 6, Sayı 2, 92 - 97, 05.05.2021
https://doi.org/10.22391/fppc.753146

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.

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

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.

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

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