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Assessment of cardiac functions using tissue Doppler imaging in children with familial Mediterranean fever

Published online by Cambridge University Press:  19 August 2011

Osman Ozdemir ,
Pinar Isik Agras ,
Yusuf Aydin ,
Ayhan Abaci ,
Samil Hizli ,
Halil Ibrahim Akkus  and
Cihan Fidan
Osman Ozdemir*
Affiliation:
Department of Paediatric Cardiology, Kecioren Training and Research Hospital, Ankara, Turkey
Pinar Isik Agras
Affiliation:
Department of Paediatric Nephrology, Kecioren Training and Research Hospital, Ankara, Turkey
Yusuf Aydin
Affiliation:
Department of Paediatrics, Kecioren Training and Research Hospital, Ankara, Turkey
Ayhan Abaci
Affiliation:
Department of Paediatrics, Kecioren Training and Research Hospital, Ankara, Turkey
Samil Hizli
Affiliation:
Department of Paediatrics, Kecioren Training and Research Hospital, Ankara, Turkey
Halil Ibrahim Akkus
Affiliation:
Department of Paediatrics, Kecioren Training and Research Hospital, Ankara, Turkey
Cihan Fidan
Affiliation:
Department of Paediatrics, Kecioren Training and Research Hospital, Ankara, Turkey
*
Correspondence to: Dr O. Ozdemir, Pinarbasi Mahallesi, Sanatoryum Caddesi, Ardahan Sokak, Kecioren Egitim ve Arastirma Hastanesi (Kecioren Training and Research Hospital), Kecioren, Ankara 06380, Turkey. Tel: +90 312 356 90 00; Fax: +90 312 356 90 02; E-mail: pedkard@gmail.com
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Abstract

Objective

Familial Mediterranean fever may carry a potential for cardiovascular disorders because of sustained inflammation during its course; however, there has been a limited number of studies investigating the cardiac functions in children. The aim of this study was to assess both ventricular diastolic functions using conventional echocardiography and tissue Doppler imaging in children with familial Mediterranean fever.

Patients and methods

The study population included 25 patients with familial Mediterranean fever – mean age was 11.8 plus or minus 5.30 years – and 23 healthy patients as controls – mean age was 9.88 plus or minus 3.69 years. Both ventricular functions were measured using echocardiography comprising standard M-mode and conventional Doppler and tissue Doppler imaging during an attack-free period.

Results

The conventional echocardiographic parameters with myocardial performance index were in normal ranges and similar in patients with familial Mediterranean fever and controls, with a p-value more than 0.05. However, right ventricular diastolic dysfunction was observed in patients with familial Mediterranean fever documented by tissue Doppler imaging, with a p-value less than 0.05 for E't and A't wave ratio.

Conclusion

Using tissue Doppler imaging, we have demonstrated that although left ventricular functions were comparable in the patients and healthy children, right ventricular diastolic function indices were impaired in patients with familial Mediterranean fever during childhood. Impaired right ventricular diastolic function may be an early manifestation of cardiac involvement in children with familial Mediterranean fever.

Keywords

Cardiac functionchildrenechocardiographyfamilial Mediterranean fevertissue Doppler imaging
Type
Original Articles
Information
Cardiology in the Young , Volume 22 , Issue 2 , 02 March 2012 , pp. 188 - 193
Copyright
Copyright © Cambridge University Press 2011

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References

1.Touitou, I. The spectrum of familial Mediterranean fever (FMF) mutations. Eur J Hum Genet 2001; 9: 473–483.Google Scholar
2.Onen, F. Familial Mediterranean fever. Rheumatol Int 2006; 26: 489–496.CrossRefGoogle ScholarPubMed
3.Baysal, T, Peru, H, Oran, B, Sahin, TK, Koksal, Y, Karaaslan, S. Left ventricular diastolic function evaluated with tissue Doppler imaging in children with familial Mediterranean fever. Clin Rheumatol 2009; 28: 23–28.CrossRefGoogle ScholarPubMed
4.Bilginer, Y, Ozaltin, F, et al. Evaluation of intima media thickness of the common and internal carotid arteries with inflammatory markers in familial Mediterranean fever as possible predictors for atherosclerosis. Rheumatol Int 2008; 28: 1211–1216.CrossRefGoogle ScholarPubMed
5.Peru, H, Altun, B, Dogan, M, Kara, F, Elmaci, AM, Oran, B. The evaluation of carotid intima-media thickness in children with familial Mediterranean fever. Clin Rheumatol 2008; 27: 689–694.CrossRefGoogle ScholarPubMed
6.Caliskan, M, Gullu, H, Yilmaz, S, et al. Impaired coronary microvascular function in familial Mediterranean fever. Atherosclerosis 2007; 195: 161–167.CrossRefGoogle ScholarPubMed
7.Choong, CY, Herrmann, HC, Weyman, AE, Fifer, MA. Preload dependence of Doppler-derived indexes of left ventricular diastolic function in humans. J Am Coll Cardiol 1987; 10: 800–808.Google Scholar
8.Gorcsan, J. Tissue Doppler echocardiography. Curr Opin Cardiol 2000; 15: 323–329.CrossRefGoogle ScholarPubMed
9.Yu, CM, Lin, H, Ho, PC, Yang, H. Assessment of left and right ventricular systolic and diastolic synchronicity in normal subjects by tissue Doppler echocardiography and the effects of age and heart rate. Echocardiography 2003; 20: 19–27.CrossRefGoogle ScholarPubMed
10.Livneh, A, Langevitz, P, Zemer, D, et al. Criteria for the diagnosis of familial Mediterranean fever. Arthritis Rheum 1997; 40: 1879–1885.Google Scholar
11.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: 273–282.Google Scholar
12.Sahn, DJ, DeMaria, A, Kisslo, J, Weyman, A. Recommendations regarding quantitation in M-mode echocardiography: results of a survey of echocardiographic measurements. Circulation 1978; 58: 1072–1083.CrossRefGoogle ScholarPubMed
13.Daniels, SR, Loggie, JM, Khoury, P, Kimball, TR. Left ventricular geometry and severe left ventricular hypertrophy in children and adolescents with essential hypertension. Circulation 1998; 97: 1907–1911.CrossRefGoogle ScholarPubMed
14.Quinones, MA, Otto, CM, Stoddard, M, Waggoner, A, Zoghbi, WA. Recommendations for quantification of Doppler echocardiography: a report from the Doppler quantification task force of the nomenclature and standards committee of the American Society of Echocardiography. J Am Soc Echocardiogr 2002; 15: 167–184.CrossRefGoogle ScholarPubMed
15.Tei, C, Ling, LH, Hodge, DO, et al. New index of combined systolic and diastolic myocardial performance: a simple and reproducible measure of cardiac function – a study in normals and dilated cardiomyopathy. J Cardiol 1995; 26: 357–366.Google ScholarPubMed
16.Tunca, M, Akar, S, Onen, F, et al. ; Turkish FMF Study Group. Familial Mediterranean fever (FMF) in Turkey: results of a nationwide multicenter study. Medicine (Baltimore) 2005; 84: 1–11.Google Scholar
17.Tutar, E, Yalcinkaya, F, Ozkaya, N, Ekim, M, Atalay, S. Incidence of pericardial effusion during attacks of familial Mediterranean fever. Heart 2003; 89: 1257–1258.CrossRefGoogle ScholarPubMed
18.Gang, N, Drenth, JP, Langevitz, P, et al. Activation of the cytokine network in familial Mediterranean fever. J Rheumatol 1999; 26: 890–897.Google ScholarPubMed
19.Panossian, A, Hambartsumyan, M, Panosyan, L, et al. Plasma nitric oxide level in familial Mediterranean fever and its modulations by Immuno-Guard. Nitric Oxide 2003; 9: 103–110.CrossRefGoogle ScholarPubMed
20.Lachmann, HJ, Sengül, B, Yavuzşen, TU, et al. Clinical and subclinical inflammation in patients with FMF and heterozygous carriers of MEFV mutations. Rheumatology (Oxford) 2006; 45: 746–750.CrossRefGoogle ScholarPubMed
21.Korkmaz, C, Ozdogan, H, Kasapcopur, O, Yazici, H. Acute phase response in familial Mediterranean fever. Ann Rheum Dis 2002; 61: 79–81.Google Scholar
22.Persson, J, Formgren, J, Israelsson, B, Berglund, G. Ultrasound-determined intima-media thickness and atherosclerosis. Direct and indirect validation. Arterioscler Thromb 1994; 14: 261–264.CrossRefGoogle ScholarPubMed
23.Dell'Italia, LJ. The right ventricle: anatomy, physiology, and clinical importance. Curr Probl Cardiol 1991; 16: 653–720.CrossRefGoogle ScholarPubMed