Impaired coronary microvascular function in familial Mediterranean fever

Abstract

Background Patients with inflammatory rheumatic diseases have an increased risk of developing atherosclerosis. However, the question of whether patients with familial Mediterranean fever (FMF) are at risk of atherosclerosis and related diseases remains controversial. Objective We aimed to use transthoracic Doppler echocardiography to investigate coronary flow reserve (CFR) and left ventricular (LV) diastolic function in patients with FMF. Methods CFR and LV diastolic function were studied in 33 patients with FMF (16 men, 17 women; mean age, 36.7 ± 12.0 years) and 35 healthy volunteers (20 men, 15 women; mean age, 36.8 ± 5.2 years). Coronary diastolic peak flow velocities (DPFV) were measured at baseline and after dipyridamole infusion. LV diastolic function was assessed by standard and tissue Doppler imaging. Results CFR was significantly lower in the FMF group than in the control group (2.27 ± 0.38 versus 3.02 ± 0.50, P < 0.0001). Significant between-group differences were found regarding LV diastolic function mitral E/ A ratio, mitral E-wave deceleration time, and lateral A m. Serum high sensitivity C-reactive protein (hsCRP) levels were significantly higher in the patients with FMF, and hsCRP values independently correlated with CFR. Conclusions Coronary microvascular function and LV diastolic function are impaired in patients with FMF. The severity of these impairments is correlated with hsCRP. Impaired CFR may be an early manifestation of cardiac involvement in patients with FMF.