QTc Dispersion Assessment in Children with Familial Mediterranean Fever

Assessment of QTc Dispersion in Children with Familial Mediterranean Fever Stj. Dr. Zeynep SOYBAY Prof. Dr. Y lmaz YOZGAT

Familial Mediterranean Fever (FMF) is the most common hereditary autoinflammatory disease in the world, manifested by inflammatory attacks such as self-limiting fever, pleuritis, peritonitis, arthritis and serositis. General prevalence of FMF in Turkey has been reported as approximately 0.1%. However, in regional scanning, this rate can go up to 1/395.

Shows autosomal recessive inheritance. As a result of the mutation in the MEFV gene located on the short arm of chromosome 16, interleukin-1 beta production increases, resulting in pyrin dysfunction that triggers inflammatory attacks.

Studies have been conducted showing that chronic inflammation increases the risk of cardiovascular disease and arrhythmia in adult FMF patients. However, the number of studies involving the pediatric FMF patient group on this subject is few. The results of the studies carried out are also controversial.

Background QTc dispersion, which is defined as the difference between the longest and the shortest QT interval in the superficial ECG, was first defined as a diagnostic method that can determine the risk of arrhythmia. Increased QTc dispersion is indicative of severe variation in ventricular repolarization.

Ventricular repolarization disorder was found in most of the studies performed on adults followed up with a diagnosis of fmf, and a prolongation of QTc dispersion on ECG was also shown.

Material and Method 45 patients followed by Bezmialem Vak f University Faculty of Medicine, Pediatric Nephrology with the diagnosis of FMF and meeting Tel-Hashomer criteria were included in our prospective study. As the control group, 45 healthy volunteers of the same age and gender were included.

Heart rate, P wave height and width, QT distance, P wave and QT interval dispersion for each patient and control group were calculated on 12-lead ECG recordings and compared with each other.

Children with arterial hypertension, left ventricular ejection fraction less than 50%, primary cardiomyopathy, congenital or rheumatic heart disease were not included in the study. All children included in our study were in sinus rhythm and none of them were using antiarrhythmics, tricyclic antidepressants, antihistamines and antipsychotics.

Results Heart rate (bpm) 110 23.9 96.8 16.5 Pmax (ms) 70.4 11.2 68.8 12.4 Pmin (ms) 38.1 8.4 44.9 10.2 PW dispersion (ms) 30.3 11.5 25 7.5 QTmax (ms) 296 33.5 302 27.3 QTmin (ms) 243 32.5 275 30.4 QT dispersion (ms) 44.6 17.9 28 8.1 QTcmax (ms) 421 25.1 403 26.3 QTcmin (ms) 359 27.2 375 25.7 QTc dispersion (ms) 66.3 24.6 34.8 14.2

Conclusion Pediatric patients diagnosed with FMF participating in our study are prone to atrial and ventricular arrhythmias due to prolonged electrocardiographic markers. We also recommended routine ECG examination for pediatric patients with FMF.

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