Korean Circulation Journal

The Korean Society of Cardiology (대한심장학회)
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Aortic Flow Propagation Velocity in Patients with Familial Mediterranean Fever: an Observational Study

  • Karaman, Kayihan (Department of Cardiology, Gaziosmanpasa University School of Medicine) ;
  • Arisoy, Arif (Department of Cardiology, Gaziosmanpasa University School of Medicine) ;
  • Altunkas, Aysegul (Department of Radiology, Gaziosmanpasa University School of Medicine) ;
  • Erken, Ertugrul (Department of Internal Medicine, Gaziosmanpasa University School of Medicine) ;
  • Demirtas, Ahmet (Department of Internal Medicine, Gaziosmanpasa University School of Medicine) ;
  • Ozturk, Mustafa (Department of Cardiology, Erzurum Territorial Training and Research Hospital) ;
  • Karayakali, Metin (Department of Cardiology, Gaziosmanpasa University School of Medicine) ;
  • Sahin, Safak (Department of Internal Medicine, Gaziosmanpasa University School of Medicine) ;
  • Celik, Atac (Department of Cardiology, Gaziosmanpasa University School of Medicine)
  • Received : 2016.11.11
  • Accepted : 2017.03.11
  • Published : 2017.07.31
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Abstract

Background and Objectives: Systemic inflammation has an important role in the initiation of atherosclerosis, which is associated with arterial stiffness (AS). Aortic flow propagation velocity (APV) is a new echocardiographic parameter of aortic stiffness. The relationship between systemic inflammation and AS has not yet been described in patients with familial Mediterranean fever (FMF). We aimed to investigate the early markers of AS in patients with FMF by measuring APV and carotid intima-media thickness (CIMT). Subjects and Methods: Sixty-one FMF patients (43 women; mean age $27.3{\pm}6.7$ years) in an attack-free period and 57 healthy individuals (36 women; mean age $28.8{\pm}7.1$ years) were included in this study. The individuals with atherosclerotic risk factors were excluded from the study. The flow propagation velocity of the descending aorta and CIMT were measured to assess AS. Results: APV was significantly lower ($60.2{\pm}16.5$ vs. $89.5{\pm}11.6cm/sec$, p<0.001) and CIMT was significantly higher ($0.49{\pm}0.09$ vs. $0.40{\pm}0.10mm$, p<0.001) in the FMF group compared to the control group. There were significant correlations between APV and mean CIMT (r=-0.424, p<0.001), erythrocyte sedimentation rate (ESR) (r=-0.198, p=0.032), and left ventricle ejection fraction (r=0.201, p=0.029). APV and the ESR were independent predictors of FMF in logistic regression analysis (OR=-0.900, 95% CI=0.865-0.936, p<0.001 and OR=-1.078, 95% CI=1.024-1.135, p=0.004, respectively). Mean CIMT and LVEF were independent factors associated with APV in linear regression analysis (${\beta}=-0.423$, p<0.001 and ${\beta}=0.199$, p=0.017, respectively) Conclusion: We demonstrated that APV was lower in FMF patients and is related to CIMT. According to our results, APV may be an independent predictor of FMF.

Keywords

References

  1. Ben-Chetrit E, Levy M. Familial Mediterranean fever. Lancet 1998;351:659-64. https://doi.org/10.1016/S0140-6736(97)09408-7
  2. Stoffman N, Magal N, Shohat T, et al. Higher than expected carrier rates for familial Mediterranean fever in various Jewish ethnic groups. Eur J Hum Genet 2000;8:307-10. https://doi.org/10.1038/sj.ejhg.5200446
  3. Touitou I. The spectrum of familial Mediterranean fever (FMF) mutations. Eur J Hum Genet 2001;9:473-83. https://doi.org/10.1038/sj.ejhg.5200658
  4. Turesson C, Jarenros A, Jacobsson L. Increased incidence of cardiovascular disease in patients with rheumatoid arthritis: results from a community based study. Ann Rheum Dis 2004;63:952-5. https://doi.org/10.1136/ard.2003.018101
  5. Laurent S, Cockcroft J, Van Bortel L, et al. Expert consensus document on arterial stiffness: methodological issues and clinical applications. Eur Heart J 2006;27:2588-605. https://doi.org/10.1093/eurheartj/ehl254
  6. Simsek H, Sahin M, Gunes Y, Dogan A, Gumrukcuoglu HA, Tuncer M. A novel echocardiographic method for the detection of subclinical atherosclerosis in newly diagnosed, untreated type 2 diabetes. Echocardiography 2013;30:644-8. https://doi.org/10.1111/echo.12125
  7. Sen T, Tufekcioglu O, Ozdemir M, et al. New echocardiographic parameter of aortic stiffness and atherosclerosis in patients with coronary artery disease: aortic propagation velocity. J Cardiol 2013;62:236-40. https://doi.org/10.1016/j.jjcc.2013.04.006
  8. Livneh A, Langevitz P, Zemer D, et al. Criteria for the diagnosis of familial Mediterranean fever. Arthritis Rheum 1997;40:1879-85. https://doi.org/10.1002/art.1780401023
  9. 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. https://doi.org/10.3109/s10165-009-0196-7
  10. Kaya EB, Yorgun H, Akdogan A, et al. Heart-rate recovery index is impaired in Behcet's disease. Tex Heart Inst J 2009;36:282-6.
  11. Rozenbaum M, Naschitz JE, Yudashkin M, et al. Cardiovascular autonomic dysfunction in familial Mediterranean fever. J Rheumatol 2002;29:987-9.
  12. Levy M, Ehrenfeld M, Levo Y, Fischel R, Zlotnick A, Eliakim M. Circulating immune complex in recurrent polyserositis. (Familial mediterranean fever periodic disease). J Rheumatol 1980;7:886-90.
  13. Roman MJ, Shanker BA, Davis A, et al. Prevalence and correlates of accelerated atherosclerosis in systemic lupus erythematosus. N Engl J Med 2003;349:2399-406. https://doi.org/10.1056/NEJMoa035471
  14. Thenappan T, Ali Raza J, Movahed A. Aortic atheromas: current concepts and controversies-a review of the literature. Echocardiography 2008;25:198-207.
  15. Caliskan M, Gullu H, Yilmaz S, et al. Impaired coronary microvascular function in familial Mediterranean fever. Atherosclerosis 2007;195:e161-7. https://doi.org/10.1016/j.atherosclerosis.2007.06.014
  16. Celermajer DS, Sorensen KE, Bull C, Robinson J, Deanfield JE. Endothelium-dependent dilatation in the systemic arteries of asymptomatic subjects relates to coronary risk factors and their interaction. J Am Coll Cardiol 1994;24:1468-74. https://doi.org/10.1016/0735-1097(94)90141-4
  17. Demiralp E, Kardesoglu E, Kiralp MZ, et al. Aortic elasticity in patients with ankylosing spondylitis. Acta Cardiol 2004;59:630-4. https://doi.org/10.2143/AC.59.6.2005246
  18. Bicer A, Acikel S, Kilic H, et al. Impaired aortic elasticity in patients with psoriasis. Acta Cardiol 2009;64:597-602. https://doi.org/10.2143/AC.64.5.2042688
  19. Wright CI, Brouwer-de Cock KA, Kroner CI, Hoeks AP, Draijer R. The relation of arterial stiffness to endothelial function in healthy subjects. Physiol Meas 2007;28:573-82. https://doi.org/10.1088/0967-3334/28/5/010
  20. Duprez DA, Cohn JN. Arterial stiffness as a risk factor for coronary atherosclerosis. Curr Atheroscler Rep 2007;9:139-44. https://doi.org/10.1007/s11883-007-0010-y
  21. Fazio GP, Redberg RF, Winslow T, Schiller NB. Transesophageal echocardiographically detected atherosclerotic aortic plaque is a marker for coronary artery disease. J Am Coll Cardiol 1993;21:144-50. https://doi.org/10.1016/0735-1097(93)90729-K
  22. Gunes A, Guntekin U, Yildiz S, et al. Association of aortic flow propagation velocity with ankle-brachial blood pressure index in patients with hypertension: an observational study. Anadolu Kardiyol Derg 2012;12:568-73.
  23. Gunes Y, Tuncer M, Yildirim M, Guntekin U, Gumrukcuoglu HA, Sahin M. A novel echocardiographic method for the prediction of coronary artery disease. Med Sci Monit 2008;14:MT42-6.
  24. Yiu KH, Yeung CK, Chan HT, et al. Increased arterial stiffness in patients with psoriasis is associated with active systemic inflammation. Br J Dermatol 2011;164:514-20.
  25. Maki-Petaja KM, Hall FC, Booth AD, et al. Rheumatoid arthritis is associated with increased aortic pulse-wave velocity, which is reduced by anti-tumor necrosis factor-alpha therapy. Circulation 2006;114:1185-92. https://doi.org/10.1161/CIRCULATIONAHA.105.601641
  26. Yildiz M, Masatlioglu S, Seymen P, Aytac E ,Sahin B, Seymen HO. The carotid-femoral (aortic) pulse wave velocity as a marker of arterial stiffness in familial Mediterranean fever. Can J Cardiol 2006;22:1127-31. https://doi.org/10.1016/S0828-282X(06)70949-7
  27. Berkun Y, Padeh S, Reichman B, et al. A single testing of serum amyloid a levels as a tool for diagnosis and treatment dilemmas in familial Mediterranean fever. Semin Arthritis Rheum 2007;37:182-8. https://doi.org/10.1016/j.semarthrit.2007.03.005
  28. Yildirim K, Uzkeser H, Keles M, et al. Relationship between serum interleukin-1beta levels and acute phase response proteins in patients with familial Mediterranean fever. Biochemia Med (Zagreb) 2012;22:109-13.
  29. Ossareh S, Alaei A, Saedi D. Carotid intima-media thickness in maintenance hemodialysis patients: role of cardiovascular risk factor. Iran J Kidney Dis 2011;5:169-74.
  30. Ugurlu S, Seyahi E, Cetinkaya F, Ozbakir F, Balci H, Ozdogan H. Intima-media thickening in patients with familial Mediterranean fever. Rheumatology (Oxford) 2009;48:911-5. https://doi.org/10.1093/rheumatology/kep131

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