Abstract:

Aims: Cardiac dysautonomia and arrhythmias can occur in chronic inflammatory conditions such as familial Mediterranean fever (FMF). The aim of this study was to evaluate the cardiac autonomic functions in patients with FMF. Methods: This was a retrospective case-control study. Electrocardiography (ECG) and 24-hour Holter ECG recordings were obtained from the medical records. T-peak to T-end intervals (Tp-e) and Tp-e/corrected QT (QTc) ratio were calculated on ECG. Heart rate variability (HRV) parameters and heart rate turbulence (HRT) parameters including turbulence onset (TO) and turbulence slope (TS) were evaluated using the 24-hour Holter ECG. All subjects were divided into three groups according to HRT parameters (HRT-0: normal TO and TS; HRT-1: abnormal TS or TO; and HRT-2: abnormal TO and TS). Results: The study included 115 individuals (age, years, mean±standard deviation: 34.5±9.6 years, 57% female, 61 FMF patients and 54 controls). Patients with FMF exhibited an increased ratio of Tp-e, Tp-e/QTc ratio (p<0.001 for both), and impairment in all HRV parameters (p<0.05 for all). Disease duration was correlated with Tp-e (r=0.402, p=0.001), Tp-e/QTc ratio (r=0.382, p=0.003) and HRV parameters (r>0.264, p<0.05 for all). Of patients with FMF, 32 (52.5%) were in the HRT-1 group, and 9 (14.8%) were in the HRT-2 group. Patients using anakinra showed more impairment in the HRV parameters (p<0.05 for all) and Tp-e/QTc ratio (p=0.041) compared to patients who were not on anakinra. Conclusions: This study showed cardiac autonomic system impairments in patients with FMF without complications, which correlated with the disease duration.

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