Korean Circ J.  2017 Jul;47(4):483-489. 10.4070/kcj.2016.0400.

Aortic Flow Propagation Velocity in Patients with Familial Mediterranean Fever: an Observational Study

• Karaman K
• Arisoy A
• Altunkas A
• Erken E
• Demirtas A
• Ozturk M
• Karayakali M
• Sahin S
• Celik A

• KMID: 2392886
• DOI: http://doi.org/10.4070/kcj.2016.0400

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±6.7 years) in an attack-free period and 57 healthy individuals (36 women; mean age 28.8±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±16.5 vs. 89.5±11.6 cm/sec, p<0.001) and CIMT was significantly higher (0.49±0.09 vs. 0.40±0.10 mm, 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 (β=-0.423, p<0.001 and β=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.

Keyword

Familial Mediterranean fever; Aortic flow propagation velocity; Arterial stiffness; Carotid intima-media thickness

MeSH Terms

Aorta, Thoracic
Atherosclerosis
Blood Sedimentation
Carotid Intima-Media Thickness
Echocardiography
Familial Mediterranean Fever*
Female
Heart Ventricles
Humans
Inflammation
Linear Models
Logistic Models
Observational Study*
Risk Factors
Vascular Stiffness

Figure

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  Fig. 1 Measurement of APV in a subject in the control group (A) and in a patient with FMF (B). APV: aortic flow propagation velocity, FMF: familial Mediterranean fever.

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  Fig. 2 Correlation between APV and CIMT. APV: aortic flow propagation velocity, CIMT: mean carotid intima-media thickness, FMF: familial Mediterranean fever.

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  Fig. 3 Receiver–operating characteristic curve analysis showing the sensitivity and specificity of APV ≤69.6 for predicting the CIMT. APV: aortic flow propagation velocity, AUC: area under curve, CI: confidence interval.

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