Background: Increased inflammatory activity is known to be a pathophysiologic characteristic of atrial fibrillation. Familial Mediterranean fever (FMF) is a disease characterized by recurrent and sustained increased inflammatory activity. Atrial conduction abnormalities in these patients have not been investigated in terms of P-wave duration, P-wave dispersion (Pd), and atrial electromechanical delay measured by tissue Doppler echocardiography (TDE). We aimed to assess atrial conduction time in patients with FMF.
Methods: A total of 33 patients with FMF (13 males/20 females, 28.4 ± 12.5 years), and 33 controls (13 males/20 females, 28.5 ± 12.1 years) were included. Atrial electromechanical coupling (PA) and intra- and interatrial electromechanical delay were measured with TDE. From the 12-lead electrocardiogram Pd was calculated.
Results: Atrial electromechanical coupling at the left lateral mitral annulus (PA lateral) was significantly higher in FMF patients (58.0 ± 9.0 vs 51.0 ± 5.8, P < 0.001). Interatrial (PA lateral–PA tricuspid) and intraatrial electromechanical delay (PA septum–PA tricuspid) were significantly longer in FMF patients (21.3 ± 7.4 vs 12.9 ± 4.6, P < 0.001 and 4.7 ± 5.5 vs 2.1 ± 1.7, P = 0.01, respectively). Also, Pd and maximum P-wave duration were significantly higher in FMF patients (42.8 ± 7.9 vs 35.3 ± 6.1, P < 0.001 and 98.6 ± 9.0 vs 93.1 ± 8.5, P = 0.01, respectively). A positive correlation was detected between interatrial electromechanical delay and Pd (r = 0.622, P < 0.001). Plasma level of C-reactive protein (CRP) correlated with interatrial electromechanical delay and Pd (r = 0.733, P < 0.001; and r = 0.427, P < 0.001, respectively).
Conclusion: This study shows that atrial electromechanical delay and Pd are prolonged in FMF patients. Atrial electromechanical delay is closely associated with Pd and plasma level of CRP.