Normal P Wave Dispersion in Colchicine-Resistant FMF Patients
DOI:
https://doi.org/10.12970/2311-052X.2014.02.01.8Keywords:
Familial Mediterranean fever (FMF), P wave dispersion, supraventricular arrhythmia, colchicine resistant FMF, chronic inflammationAbstract
Background: Cardiac involvement in familial Mediterranean fever (FMF) has been receiving increasing attention. P wave dispersion (Pd) is an electrocardiographic marker for supraventricular arrhythmias. It was recently reported that uncomplicated FMF is associated with normal Pd.
Aims: Our aim was to evaluate Pd and P wave duration in colchicine-resistant FMF patients, thus testing the effect of the continuously increased inflammatory burden on cardiac electrical stability of FMF patients.
Methods: Twenty two patients with colchicine-resistant FMF, and 22 age- and sex-matched control subjects were investigated. All participants underwent a 12-lead electrocardiography under strict standards. P wave length and P wave dispersion were computed from a randomly selected beat and an averaged beat constructed from 7-12 beats in a 10 second ECG.
Results: Minimal, maximal, and average P wave duration and P wave dispersion calculated from either a random beat or averaged beats, were similar in colchicine-resistant FMF patients and healthy individuals.
Conclusions: FMF patients, nonresponsive to colchicine treatment, but without amyloidosis, have normal atrial conduction parameters. Therefore, FMF, even in colchicine nonresponsive patients, does not seem to be associated with an increased risk for supraventricular arrhythmias.
References
Lidar M, Livneh A. Familial Mediterranean fever: clinical, molecular and management advancements. Neth J Med 2007; 65: 318-24.
Mor A, Shinar Y, Zaks N, et al. Evaluation of disease severity in familial Mediterranean fever. Semin Arthritis Rheum 2005; 35: 57-64. http://dx.doi.org/10.1016/j.semarthrit.2005.02.002
Zemer D, Revach M, Pras M, et al. A controlled trial of colchicine in preventing attacks of familial mediterranean fever. N Engl J Med 1974; 291: 932-4. http://dx.doi.org/10.1056/NEJM197410312911803
Ben-Zvi I, Livneh A. Chronic inflammation in FMF: markers, risk factors, outcomes and therapy. Nat Rev Rheumatol 2011; 7: 105-12. http://dx.doi.org/10.1038/nrrheum.2010.181
Langevitz P, Livneh A, Neumann L, et al. Prevalence of ischemic heart disease in patients with familial Mediterranean fever. Isr Med Assoc J 2001; 3: 9-12.
Gertz MA, Kyle RA. Secondary systemic amyloidosis: response and survival in 64 patients. Medicine (Baltimore) 1991; 70: 246-56. http://dx.doi.org/10.1097/00005792-199107000-00002
Akdogan A, Calguneri M, Yavuz B, et al. Are familial Mediterranean fever (FMF) patients at increased risk for atherosclerosis? Impaired endothelial function and increased intima media thickness are found in FMF. J Am Coll Cardiol 2006; 48: 2351-3. http://dx.doi.org/10.1016/j.jacc.2006.09.013
Sari I, Karaoglu O, Can G, et al. Early ultrasonographic markers of atherosclerosis in patients with familial Mediterranean fever. Clin Rheumatol 2007; 26: 1467-73. http://dx.doi.org/10.1007/s10067-006-0529-2
Akcay A, Acar G, Sayarlioglu M, et al. QT dispersion and transmural dispersion of repolarization in patients with familial Mediterranean fever. Mod Rheumatol 2009; 19: 550-5. http://dx.doi.org/10.3109/s10165-009-0196-7
Nussinovitch N, Livneh A, Katz K, et al. P wave dispersion in familial Mediterranean fever. Rheumatol Int 2011; 31: 1591-4. http://dx.doi.org/10.1007/s00296-010-1508-0
Nussinovitch U, Katz U, Nussinovitch M, Nussinovitch N. P-wave dispersion in familial dysautonomia. Isr Med Assoc J 2010; 12: 729-31.
Acar G, Akcay A, Sayarlioglu M, et al. Assessment of atrial conduction time in patients with familial Mediterranean fever. Pacing Clin Electrophysiol 2009; 32: 308-13. http://dx.doi.org/10.1111/j.1540-8159.2008.02237.x
Livneh A, Langevitz P, Zemer D, et al. Criteria for the diagnosis of familial Mediterranean fever. Arthritis Rheum 1997; 40: 1879-85. http://dx.doi.org/10.1002/art.1780401023
Lidar M, Scherrmann JM, Shinar Y, et al. Colchicine nonresponsiveness in familial Mediterranean fever: clinical, genetic, pharmacokinetic, and socioeconomic characterization. Semin Arthritis Rheum 2004; 33: 273-82. http://dx.doi.org/10.1053/S0049-0172(03)00137-9
Hubacek JA. Eat less and exercise more - is it really enough to knock down the obesity pandemia? Physiol Res 2009; 58 (Suppl 1): S1-6.
Kose S, Aytemir K, Can I, et al. Seasonal variation of P-wave dispersion in healthy subjects. J Electrocardiol 2002; 35: 307-11. http://dx.doi.org/10.1054/jelc.2002.35848
Michelucci A, Bagliani G, Colella A, et al. P wave assessment: state of the art update. Card Electrophysiol Rev 2002; 6: 215-20. http://dx.doi.org/10.1023/A:1016368723033
Perzanowski C, Ho AT, Jacobson AK. Increased P-wave dispersion predicts recurrent atrial fibrillation after cardioversion. J Electrocardiol 2005; 38: 43-6. http://dx.doi.org/10.1016/j.jelectrocard.2004.09.008
Dilaveris PE, Gialafos JE. P-wave dispersion: a novel predictor of paroxysmal atrial fibrillation. Ann Noninvasive Electrocardiol 2001; 6: 159-65. http://dx.doi.org/10.1111/j.1542-474X.2001.tb00101.x
