P-wave duration and dispersion in children with uncomplicated familial Mediterranean fever

Area of Science:

• Cardiology
• Pediatrics
• Genetics

Background:

• Familial Mediterranean fever (FMF) is a genetic autoinflammatory disorder.
• Cardiac involvement in FMF, particularly atrial abnormalities, requires further investigation.
• Electrocardiographic parameters like P-wave duration and dispersion are sensitive indicators of atrial electrical activity.

Purpose of the Study:

• To investigate P-wave duration (Pdu) and P-wave dispersion (Pd) in children with uncomplicated FMF.
• To compare these electrocardiographic parameters between FMF patients and healthy controls.
• To explore correlations between P-wave dispersion and inflammatory markers or cardiac function in FMF.

Main Methods:

• A prospective controlled study involving 26 children with uncomplicated FMF and 25 age- and sex-matched healthy controls.
• 12-lead electrocardiography (ECG) was performed on all participants under strict standards.
• Pdu and Pd were calculated from averaged ECG beats, with Doppler echocardiography also utilized.

Main Results:

• While left ventricle and left atrium dimensions were normal, significant differences were observed in LV-isovolumic relaxation time (IRT), LV-isovolumic contraction time (ICT), right ventricle (RV)-ICT, RV-IRT, and P-wave dispersion (Pd) between groups (p < 0.0001).
• Highly significant positive correlations were found between Pd and LV-ICT, LV-IRT, RV-ICT, RV-IVT, and C-reactive protein (CRP).
• These findings suggest subclinical atrial electrical abnormalities in FMF patients.

Conclusions:

• Children with uncomplicated FMF, even when treated with colchicine and without amyloidosis, exhibit abnormal atrial dispersion.
• This abnormal atrial dispersion suggests an increased electrocardiographic risk for atrial fibrillation in these patients.
• Further cardiac monitoring may be warranted for pediatric FMF patients to assess atrial electrophysiological changes.