Ailevi akdeniz ateşi tanılı çocuklarda kalp ileti sistemindeki değişikliklerin değerlendirilmesi
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Dosyalar
Tarih
2020
Yazarlar
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Dergi ISSN
Cilt Başlığı
Yayıncı
Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Ailevi Akdeniz Ateşi (FMF), ateş ve steril poliserozit atakları ile karakterize, genetik geçişli, tekrarlayan otoinflamatuvar bir hastalıktır. Ailevi Akdeniz Ateşi tanılı çocuk hastaların elektrokardiyografik ölçümlerinde kardiyak ileti sistemindeki değişikliklerinin saptanması amacıyla bu çalışma yapılmıştır. Yöntem: Çalışmaya Aralık 2019- Nisan 2020 tarihleri arasında FMF tanısıyla takip edilen 87 çocuk hasta ve aynı yaş grubunda sağlıklı 87 olgu dahil edildi. Hasta grubun laboratuvar parametreleri ve genetik analizleri ile birlikte tüm olguların demografik özellikleri değerlendirildi. Her iki grupta elektrokardiyografide atriyal ve ventriküler aritmi riski belirteçleri ve standart ekokardiyografi ölçümleri yapıldı. İstatistiksel analizler için SPSS 25 paket programı kullanıldı. p<0,05 olması anlamlı kabul edildi Bulgular: Hasta grubun yaş ortalaması 10,30±4,02 yıl ve kontrol grubun ise 10,03±3,93 yıl idi. Hasta grubunun; %49,04'ü kız (n=43) %50,6'sı erkek (n=44), kontrol grubunun; %55,2'si kız (n=48) ve %44,8'i (n=39) erkek idi. Hasta ve kontrol grupları arasında yaş, cinsiyet, boy, kilo, vücut kitle indeksi ve tansiyon değerleri bakımından istatistiksel olarak anlamlı fark yoktu. Ailevi Akdeniz Ateşi tanısıyla takipli hastaların genetik incelemelerinde %18,4 homozigot mutasyon, %17,2 heterozigot mutasyon ve %25,3 compound heterozigot mutasyon olduğu görüldü. Hastaların %11,5'inde mutasyona rastlanmazken, %27,6 hastanın genetik sonuçlarına ulaşılamadı. Hasta ve kontrol grubunun standart ekokardiyografik incelemesinde kalp yapı ve fonksiyonlarının iki grupta birbirine benzer olduğu görüldü. Elektrokardiyografi incelemelerinde hasta grubunda P dispersiyonu (Pd), QT dispersiyonu (QTd), düzeltilmiş QTd (QTcd), Tp-e, Tp-e /QT ve Tp-e/QTc değerleri kontrol grubuna göre istatistiksel olarak yüksek bulunmuştur (p<0,001). Ayrıca hasta grubunda ventriküler repolarizasyon parametrelerinin önemli bir kısmının da birbiriyle anlamlı derecede korele olduğu görülmüştür (p<0,05). Sonuç: Çalışmamızda; FMF tanılı çocuk hastalarda kontrol grubuna göre atriyal depolarizasyon (Pd) ve ventriküler repolarizayon (QTd, QTcd, Tp-e, Tp-e/QT, TP-e/QTc) belirteçleri yüksek saptandı. Bu durum hastalığın kardiyak aritmiler için risk oluşturabileceğini düşündürmektedir. Bununla birlikte altta yatan mekanizma ve aritmojenik potansiyeli aydınlatmak için uzun süreli kapsamlı çalışmalara ihtiyaç vardır.
Familial Mediterranean Fever (FMF) is a genetic, recurrent autoinflammatory disease characterized by episodes of fever and sterile polyserositis. This study was conducted in order to determine changes in cardiac conduction system via electrocardiographic measurements of pediatric patients diagnosed with Familial Mediterranean Fever. Method: Eighty-seven pediatric patients who were being followed-up with the diagnosis of FMF between December 2019 and April 2020, and 87 age-matched healthy cases were included in the study. Demographic characteristics of all cases, together with laboratory parameters and genetic analyses of the patient group were evaluated. For both groups, atrial and ventricular arrhythmia risk markers in electrocardiography and standard echocardiographic measurements were obtained. For statistical analyses, SPSS 25 package program was used. A p <0.05 was considered significant. Results: Mean age was 10.30±4.02 years in the patient group and 10.03±3.93 years in the control group. Of the patient group; 49.04% (n=43) were female and 50.6% (n=44) male, whereas of the control group; 55.2% (n=48) were female and 44.8% (n=39) male. There were no statistical differences between the patient and control groups in regard to age, gender, height, weight, body mass index and blood pressure values. In genetic examinations of patients diagnosed with Familial Mediterranean Fever; 18.4% were determined to have homozygous mutation, 17.2% heterozygous mutation and 25.3% compound heterozygous mutation. Of patients, 11.5% had no mutation and genetic results of 27.6% could not be reached. Cardiac structure and functions of the patient and control groups with standard echocardiographic examination were found to be similar. In electrocardiographic examination, P dispersion (Pd), QT dispersion (QTd), corrected QTd (QTcd), Tp-e, Tp-e /QT and Tp-e/QTc values were determined to be statistically higher in the patient group compared to the control group (p<0.001). Furthermore, in the patient group, significant correlations were observed between the majority of ventricular repolarization parameters (p<0.05). Conclusion: In our study, atrial depolarization (Pd) and ventricular repolarization (QTd, QTcd, Tp-e, Tp-e/QT, TP-e/QTc) markers were determined to be higher in pediatric patients with FMF compared to control group. This suggests that the disease may pose a risk for cardiac arrhythmias. However, extensive studies with longer durations are needed in order to clarify the underlying mechanism and arrhythmogenic potential.
Familial Mediterranean Fever (FMF) is a genetic, recurrent autoinflammatory disease characterized by episodes of fever and sterile polyserositis. This study was conducted in order to determine changes in cardiac conduction system via electrocardiographic measurements of pediatric patients diagnosed with Familial Mediterranean Fever. Method: Eighty-seven pediatric patients who were being followed-up with the diagnosis of FMF between December 2019 and April 2020, and 87 age-matched healthy cases were included in the study. Demographic characteristics of all cases, together with laboratory parameters and genetic analyses of the patient group were evaluated. For both groups, atrial and ventricular arrhythmia risk markers in electrocardiography and standard echocardiographic measurements were obtained. For statistical analyses, SPSS 25 package program was used. A p <0.05 was considered significant. Results: Mean age was 10.30±4.02 years in the patient group and 10.03±3.93 years in the control group. Of the patient group; 49.04% (n=43) were female and 50.6% (n=44) male, whereas of the control group; 55.2% (n=48) were female and 44.8% (n=39) male. There were no statistical differences between the patient and control groups in regard to age, gender, height, weight, body mass index and blood pressure values. In genetic examinations of patients diagnosed with Familial Mediterranean Fever; 18.4% were determined to have homozygous mutation, 17.2% heterozygous mutation and 25.3% compound heterozygous mutation. Of patients, 11.5% had no mutation and genetic results of 27.6% could not be reached. Cardiac structure and functions of the patient and control groups with standard echocardiographic examination were found to be similar. In electrocardiographic examination, P dispersion (Pd), QT dispersion (QTd), corrected QTd (QTcd), Tp-e, Tp-e /QT and Tp-e/QTc values were determined to be statistically higher in the patient group compared to the control group (p<0.001). Furthermore, in the patient group, significant correlations were observed between the majority of ventricular repolarization parameters (p<0.05). Conclusion: In our study, atrial depolarization (Pd) and ventricular repolarization (QTd, QTcd, Tp-e, Tp-e/QT, TP-e/QTc) markers were determined to be higher in pediatric patients with FMF compared to control group. This suggests that the disease may pose a risk for cardiac arrhythmias. However, extensive studies with longer durations are needed in order to clarify the underlying mechanism and arrhythmogenic potential.
Açıklama
Anahtar Kelimeler
Ailevi Akdeniz Ateşi, Ekokardiyografi, Elektrokardiyografi, Kardiyak İleti Sistemi, Echocardiography, Electrocardiography, Familial Mediterranean Fever
Kaynak
WoS Q Değeri
Scopus Q Değeri
Cilt
Sayı
Künye
Uğurlu, B. (2020). Ailevi akdeniz ateşi tanılı çocuklarda kalp ileti sistemindeki değişikliklerin değerlendirilmesi. (Yayınlanmamış tıpta uzmanlık tezi) Necmettin Erbakan Üniversitesi, Meram Tıp Fakültesi Dahili Tıp Bilimleri Bölümü Çocuk Sağlığı ve Hastalıkları Anabilim Dalı, Konya.
