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The detailed assessment of left and right ventricular functions by tissue Doppler imaging in patients with familial Mediterranean fever

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Abstract

In the contrary to other rheumatologic disorders, there have been limited numbers of studies investigating the cardiac involvement in patients with familial Mediterranean fever (FMF), although the disease may carry a potential for cardiovascular disorders because of sustained inflammation during its course. In the present study, we used high usefulness tissue Doppler echocardiography for detailed analysis of cardiac changes in FMF patients. The study population included 30 patients with FMF (11 men, 19 women; mean age, 35 ± 7 years, mean disease duration, 15.4 ± 7.6 years) and 30 healthy subjects as controls (12 men, 18 women; mean age, 33 ± 7 years). The diagnosis of FMF was established according to the Tell–Hashomer criteria. Left and right ventricular functions were measured using echocardiography comprising standard two-dimensional, M-mode, and conventional Doppler as well as tissue Doppler imaging. The conventional echocardiographic paratemeters were similar apart from left ventricular relaxation time was longer (107 ± 25 vs 85 ± 10 ms, p < 0.001, respectively) in patients with FMF. According to the tissue Doppler measurements, while systolic velocities of both ventricles were not different, diastolic filling velocities of left ventricle including E′m (12.6 ± 3.4 vs 14.7 ± 3.3 cm/s, p = 0.04), A′m (10.1 ± 2.6 vs 8.6 ± 2.0 cm/s, p = 0.015), and E′m/ A′m (1.24 ± 0.4 vs 1.71 ± 0.5 cm/s, p = 0.012) values were statistically different between the groups. Left ventricular myocardial performance indices and right ventricular diastolic functions were found similar between two groups. In addition, there were no significant correlations between the disease duration, clinical features, and echocardiographic parameters. In conclusion, we have demonstrated that although systolic functions were comparable in the patients and controls, left ventricular diastolic function indices were impaired in FMF patients by using tissue Doppler analysis.

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References

  1. Ben-Chetrit E, Levy M (1998) Familial Mediterranean fever. Lancet 351:659–664

    Article  PubMed  CAS  Google Scholar 

  2. Koklu S, Ozturk MA, Balci M, Yuksel O, Ertenli I, Kiraz S (2005) Interferon-gamma levels in familial Mediterranean fever. Jt Bone Spine 72:38–40

    Article  Google Scholar 

  3. Haznedaroglu S, Ozturk MA, Sancak B, Goker B, Onat AM, Bukan N, Ertenli I, Kiraz S, Calguneri M (2005) Serum interleukin 17 and interleukin 18 levels in familial Mediterranean fever. Clin Exp Rheumatol 23(Suppl 38):S77–S80

    PubMed  CAS  Google Scholar 

  4. Livneh A, Langevitz P, Zemer D, Zaks N, Kees S, Lidar T, Migdal A, Padeh S, Pras M (1997) Criteria for the diagnosis of familial Mediterranean fever. Arthritis Rheum 40:1879–1885

    Article  PubMed  CAS  Google Scholar 

  5. Tunca M, Akar S, Onen F, Ozdogan H, Kasapcopur O, Yalcinkaya F, Tutar E, Ozen S, Topaloglu R, Yilmaz E, Arici M, Bakkaloglu A, Besbas N, Akpolat T, Dinc A, Erken E, Turkish FMF Study Group (2005) Familial Mediterranean fever (FMF) in Turkey: results of a nationwide multicenter study. Medicine (Baltimore) 84:1–11

    Article  Google Scholar 

  6. Tei C, Ling LH, Hodge DO, Bailey KR, Oh JK, Rodeheffer RJ et al (1995) 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 26:357–366

    PubMed  CAS  Google Scholar 

  7. Tei C, Nishimura RA, Seward JB, Tajik AJ (1997) Noninvasive Doppler-derived myocardial performance index: correlation with simultaneous measurements of cardiac catheterization measurements. J Am Soc Echocardiogr 10:169–178

    Article  PubMed  CAS  Google Scholar 

  8. Choong CY, Herrmann HC, Weyman AE, Fifer MA (1987) Preload dependence of Doppler-derived indexes of left ventricular diastolic function in humans. J Am Coll Cardiol 10:800–808

    Article  PubMed  CAS  Google Scholar 

  9. Oki T, Tabata T, Yamada H, Wakatsuki T, Shinohara H, Nishikado A et al (1997) Clinical application of pulsed Doppler tissue imaging for assessment of abnormal left ventricular relaxation. Am J Cardiol 79:921–928

    Article  PubMed  CAS  Google Scholar 

  10. Sahn DJ, DeMaria A, Kisslo J, Weyman A (1978) Recommendations regarding quantification in M-mode echocardiography: results of a survey of echocardiographic measurements. Circulation 58:1072–1083

    PubMed  CAS  Google Scholar 

  11. Simonson JS, Schiller NB (1989) Descent of the base of the left ventricle: an echocardiographic index of the left ventricular functions. J Am Soc Echocardiogr 2:25–35

    PubMed  CAS  Google Scholar 

  12. Gulati VK, Katz WE, Follansbee WP, Gorcsan J 3rd (1996) Mitral annular descent velocity by tissue Doppler echocardiography as an index of global left ventricular function. Am J Cardiol 77:979–984

    Article  PubMed  CAS  Google Scholar 

  13. Rakowski H, Appleton C, Chan KL, Dumesnil JG, Honos G, Jue J et al (1996) Canadian consensus recommendations for the measurement and reporting of diastolic dysfunction by echocardiography: from the Investigators of Consensus on Diastolic Dysfunction by Echocardiography. J Am Soc Echocardiogr 9:736–760

    Article  PubMed  CAS  Google Scholar 

  14. Smith JL, Bolson EL, Wong SP, Hubka M, Sheehan FH (2003) Three-dimensional assessment of two-dimensional technique for evaluation of right ventricular function by tricuspid annulus motion. Int J Cardiovasc Imaging 19:189–197

    Article  PubMed  CAS  Google Scholar 

  15. Kaul S, Tei C, Hopkins JM, Shah PM (1984) Assessment of right ventricular function using two dimensional echocardiography. Am Heart J 128:301–307

    Google Scholar 

  16. Wong M, Toh L, Wilson A, Rowley K, Karschimkus C, Prior D et al (2003) Reduced arterial elasticity in rheumatoid arthritis and the relationship to vascular disease risk factors and inflammation. Arthritis Rheum 48:81–89

    Article  PubMed  Google Scholar 

  17. Selzer F, Sutton-Tyrrell K, Fitzgerald S, Tracy R, Kuller L, Manzi S (2001) Vascular stiffness in women with systemic lupus erythematosus. Hypertension 37:1075–1082

    PubMed  CAS  Google Scholar 

  18. Montecucco C, Gobbi G, Perlini S, Rossi S, Grandi AM, Caporali R, Finardi G (1999) Impaired diastolic function in active rheumatoid arthritis. Relationship with disease duration. Clin Exp Rheumatol 17:407–412

    PubMed  CAS  Google Scholar 

  19. Ozkan M, Emel O, Ozdemir M et al (1992) M-mode and Doppler echocardiographic study in 65 patients with Behcet’s syndrome. Eur Heart J 13:638–641

    PubMed  CAS  Google Scholar 

  20. Langevitz P, Livneh A, Neumann L, Buskila D, Shemer J, Amolsky D, Pras M (2001) Prevalence of ischemic heart disease in patients with familial Mediterranean fever. Isr Med Assoc J 3:9–12

    PubMed  CAS  Google Scholar 

  21. Ozbalkan Z, Ozturk MA, Onat AM, Ureten K, Haznedaroglu IC, Kiraz S, Ertenli AI, Kirazli S, Calguneri M (2006) Circulating thrombomodulin levels in familial Mediterranean fever. Clin Exp Rheumatol 24(5 Suppl 42):S095–S098

    Google Scholar 

  22. Başar O, Öztürk MA, Köklü S, Ayaz S, Yüksel O, Kiraz S, Ertenli I, Çalgüneri M (2007) Serum levels of soluble vascular endothelial growth factor receptor-1 (sVEGFR-1) in familial Mediterranean fever. Jt Bone Spine 74:52–55

    Article  CAS  Google Scholar 

  23. Akdogan A, Calguneri M, Yavuz B, Arslan EB, Kalyoncu U, Sahiner L, Karadag O, Ertenli I, Kiraz S, Aytemir K, Akata D, Tokgozoglu L, Oto A (2006) 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 48:2351–2353

    Article  PubMed  Google Scholar 

  24. Yildiz M, Masatlioglu S, Seymen P, Aytac E, Sahin B, Seymen HO (2006) The carotid–femoral (aortic) pulse wave velocity as a marker of arterial stiffness in familial Mediterranean fever. Can J Cardiol 22:1127–1131

    PubMed  Google Scholar 

  25. Grimaldi MP, Candore G, Vasto S, Caruso M, Caimi G, Hoffmann E, Colonna-Romano G, Lio D, Shinar Y, Franceschi C, Caruso C (2006) Role of the pyrin M694V (A2080G) allele in acute myocardial infarction and longevity: a study in the Sicilian population. J Leukoc Biol 79:611–615

    Article  PubMed  CAS  Google Scholar 

  26. Ben-Chetrit E, Levy M (2001) Enigmas in familial Mediterranean fever. Clin Exp Rheumatol 19(Suppl 24):S1–S5

    PubMed  Google Scholar 

  27. de Beer FC, Mallya RK, Fagan EA, Lanham JG, Hughes GRV, Pepys MB (1982) Serum amyloid A protein (SAA) concentration in inflammatory diseases and its relationship to the incidence of reactive systemic amyloidosis. Lancet 31:231–234

    Google Scholar 

  28. Gafni J, Ravid M, Sohar E (1968) The role of amyloidosis in familial Mediterranean fever. A population study. Isr J Med 4:995–999

    CAS  Google Scholar 

  29. Heller H, Sohar E, Gafni J, Heller J (1961) Amyloidosis in familial Mediterranean fever. Arch Intern Med 107:539–550

    PubMed  CAS  Google Scholar 

  30. Dilsen N, Gul A, Mege JL, Sanguedolce MV (1992) Tumour necrosis factor in pathogenesis of familial Mediterranean fever. Am J Med 93:587

    Article  PubMed  CAS  Google Scholar 

  31. Direskeneli H, Ozdogan H, Korkmaz C, Akoglu T, Yazici H (1999) Serum soluble intercellular adhesion molecule 1 and interleukin 8 levels in familial Mediterranean fever. J Rheumatol 26:1983–1986

    PubMed  CAS  Google Scholar 

  32. Gang N, Drenth JP, Langevitz P, Zemer D, Brezniak N, Pras M, Meer JW, Livneh A (1999) Activation of the cytokine network in familial Mediterranean fever. J Rheumatol 26:890–897

    PubMed  CAS  Google Scholar 

  33. Erken E, Ozer HT, Gunesacar R (2006) Plasma interleukin-10 and interleukin-12 levels in patients with familial Mediterranean fever. Rheumatol Int 26:862–864

    Article  PubMed  CAS  Google Scholar 

  34. Katsuda S, Okada Y, Imai K et al (1994) Matrix metaloproteinase 9 (92Kd gelatinase/typeIV collagenase) can degrade arterial elastin. Am J Pathol 144:1208–1218

    Google Scholar 

  35. Eagleton MJ, Peterson DA, Sullivan VV, Roelofs KJ, Ford JA, Stanley JC, Upchurch GR Jr (2002) Nitric oxide inhibition increases aortic wall matrix metalloproteinase 9 expression. J Surg Res 104:15–21

    Article  PubMed  CAS  Google Scholar 

  36. Panossian A, Hambartsumyan M, Panosyan L, Abrahamyan H, Mamikonyan G, Gabrielyan E, Amaryan G, Astvatsatryan V, Wikman G (2003) Plasma nitric oxide level in familial Mediterranean fever and its modulations by Immuno-Guard. Nitric Oxide 9:103–110

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Cardiology, Gazi University School of Medicine, Beşevler, 06500, Ankara, Turkey

    Yusuf Tavil, Nihat Şen, Mehmet Güngör Kaya, Mustafa Cemri & Atiye Çengel

  2. Department of Rheumatology, Ministry of Healthy Etlik Education and Research Hospital, Ankara, Turkey

    Kemal Üreten

  3. Department of Rheumatology, Gazi University School of Medicine, Ankara, Turkey

    Mehmet Akif Öztürk

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  1. Yusuf Tavil
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  2. Kemal Üreten
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Correspondence to Yusuf Tavil.

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Tavil, Y., Üreten, K., Öztürk, M.A. et al. The detailed assessment of left and right ventricular functions by tissue Doppler imaging in patients with familial Mediterranean fever. Clin Rheumatol 27, 189–194 (2008). https://doi.org/10.1007/s10067-007-0676-0

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  • DOI: https://doi.org/10.1007/s10067-007-0676-0

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