Ayşe Bahar KELEŞOĞU DİNÇER, Haluk Furkan ŞAHAN

Ailevi Akdeniz Ateşi olan erişkin hastalarda koroner arter hastalığının belirteci olarak epikardiyal yağ doku kalınlığının değerlendirilmesi

Amaç: Ailevi Akdeniz Ateşi (FMF), ataklar halinde giden kronik otoinflamatuvar bir hastalıktır. Ataklar arası dönemde subklinik düzeyde inflamasyonun devam etmesi nedeniyle bu hastalarda artmış ateroskleroz riski mevcuttur. Epikardiyal yağ doku yeni bir kardiyometabolik risk faktörü olup aterosklerotik riskin belirlenmesinde kullanılmaktadır. Bu çalışmanın amacı FMF tanısı ile takip edilen erişkin hastalarda epikardiyal yağ doku kalınlığının ölçülmesi ve subklinik aterosklerotik hastalık riskinin değerlendirilmesidir. Gereç ve yöntemler: Tel-Hashomer kriterlerine göre tanı almış 18 yaş ve üzeri FMF hastası ile yaş ve cinsiyet uyumlu sağlıklı kontrol bu kesitsel çalışmaya dahil edilmiştir. Hastalık özellikleri, FMF gen mutasyonları ve eritrosit sedimentasyon hızı, C-reaktif protein, serum amiloid-A, fibrinojen, lipid düzeyleri ve tam kan sayımları çalışmaya dahil edilme esnasında kaydedilmiştir. Epikardiyal yağ doku kalınlığı, iki boyutlu transtorasik ekokardiyografi ile ölçülmüştür. P değeri

Anahtar Kelimeler:

Ailesel Akdeniz Ateşi, Koroner Arter Hastalığı, Ekokardiyografi, İnflamasyon

Epicardial adipose tissue thickness in adult patients with Familial Mediterranean Fever as a predictor of coronary artery disease

Aim: Familial Mediterranean Fever (FMF), is a chronic auto-inflammatory disease characterized with recurrent attacks. In between attacks, subclinical inflammation persists which results in increased risk of atherosclerosis. Epicardial adipose tissue is a novel cardiometabolic risk factor which predicts the risk of atherosclerosis. The aim of this study was to measure the epicardial adipose tissue thickness (EATT) and to evaluate the risk of subclinical atherosclerosis in patients with FMF. Materials and Methods: 18 years old and older FMF patients diagnosed according to Tel-Hashomer criteria and age and sex matched healthy individuals were recruited for this cross-sectional study. Disease characteristics, gene mutations, erythrocyte sedimentation rate, C-reactive protein, serum amyloid-A, fibrinogen, lipid levels and complete blood counts were recorded at the time of inclusion. EATT was measured by a two-dimensional transthoracic echocardiography. A p value

Keywords:

Familial Mediterranean Fever, Coronary Artery Disease, Echocardiography, Inflammation,

PDF

___

1. Sönmez HE, Batu ED, Özen S. Familial Mediterranean fever: current perspectives. Journal of inflammation research. 2016;9:13.
2. Onen F. Familial mediterranean fever. Rheumatology international. 2006;26(6):489-96.
3. Migita K, Asano T, Sato S, et al. Familial Mediterranean fever: overview of pathogenesis, clinical features and management. Immunological medicine. 2018;41(2):55-61.
4. Chung CP, Avalos I, Raggi P, et al. Atherosclerosis and inflammation: insights from rheumatoid arthritis. Clinical rheumatology. 2007;26(8):1228-33.
5. Yüksel Ş, Ayvazyan L, Gasparyan AY. Familial Mediterranean fever as an emerging clinical model of atherogenesis associated with low-grade inflammation. The open cardiovascular medicine journal. 2010;4:51.
6. Livnehneh A, Langevitz P, Zemer D, et al. The changing face of familial Mediterranean fever. Seminars in arthritis and rheumatism; 1996: Elsevier.
7. Boyraz I, Onur CS, Erdem F. Assessment of relation between neutrophil lympocyte, platelet lympocyte ratios and epicardial fat thickness in patients with ankylosing spondylitis. Med Glas (Zenica). 2016;13(1):14-7.
8. Packer M. Epicardial adipose tissue may mediate deleterious effects of obesity and inflammation on the myocardium. Journal of the American College of Cardiology. 2018;71(20):2360-72.
9. Iacobellis G, Bianco AC. Epicardial adipose tissue: emerging physiological, pathophysiological and clinical features. Trends in Endocrinology & Metabolism. 2011;22(11):450-7.
10. Pierdomenico SD, Pierdomenico AM, Cuccurullo F,et al. Meta-analysis of the relation of echocardiographic epicardial adipose tissue thickness and the metabolic syndrome. The American journal of cardiology. 2013;111(1):73-8.
11. Temiz A, Gökmen F, Gazi E, et al. Epicardial adipose tissue thickness, flow-mediated dilatation of the brachial artery, and carotid intima–media thickness. Herz. 2015;40(3):217-24.
12. Lipson A, Alexopoulos N, Hartlage GR, et al. Epicardial adipose tissue is increased in patients with systemic lupus erythematosus. Atherosclerosis. 2012;223(2):389-93.
13. Livneh A, Langevitz P, Zemer D, et al. Criteria for the diagnosis of familial Mediterranean fever. Arthritis & Rheumatism. 1997;40(10):1879-85.
14. Nishimura RA, Miller Jr FA, Callahan MJ, et al. Doppler echocardiography: theory, instrumentation, technique, and application. Mayo Clinic Proceedings; 1985: Elsevier.
15. Tajik AJ, Seward J, Hagler D, et al. Two-dimensional real-time ultrasonic imaging of the heart and great vessels. Technique, image orientation, structure identification, and validation. Mayo Clinic Proceedings; 1978.
16. Sahn DJ, DeMaria A, Kisslo J, et al. Recommendations regarding quantitation in M-mode echocardiography: results of a survey of echocardiographic measurements. circulation. 1978;58(6):1072-83.
17. Iacobellis G, Ribaudo MC, Assael F, et al. Echocardiographic epicardial adipose tissue is related to anthropometric and clinical parameters of metabolic syndrome: a new indicator of cardiovascular risk. The Journal of Clinical Endocrinology & Metabolism. 2003;88(11):5163-8.
18. Moriya J. Critical roles of inflammation in atherosclerosis. Journal of cardiology. 2019;73(1):22-7.
19. Arida A, Protogerou AD, Kitas GD,et al. Systemic inflammatory response and atherosclerosis: the paradigm of chronic inflammatory rheumatic diseases. International journal of molecular sciences. 2018;19(7):1890.
20. Kozan M, Ozan ZT, Demir V, et al. The relation of novel cardiovascular risk parameters in patients with familial Mediterranean fever. JRSM cardiovascular disease. 2019;8:2048004018823856.
21. Alsarah A, Alsara O, Laird-Fick HS. Cardiac manifestations of Familial Mediterranean fever. Avicenna journal of medicine. 2017;7(4):158.
22. Uluca Ü, Demir F, Ece A, et al. Assessment of epicardial adipose tissue thickness and the mean platelet volume in children with familial Mediterranean fever. Italian journal of pediatrics. 2015;41(1):1-4.
23. Ghobrial EE, Farag YM, Abdul-Aziz DM, et al. Assessment of Epicardial Adipose Tissue Thickness in Children with Familial Mediterranean Fever. Journal of tropical pediatrics. 2020;66(2):121-8.
24. Ormseth MJ, Lipson A, Alexopoulos N, et al. Association of epicardial adipose tissue with cardiometabolic risk and metabolic syndrome in patients with rheumatoid arthritis. Arthritis care & research. 2013;65(9):1410-5.
25. Ganjali S, Gotto Jr AM, Ruscica M, et al. Monocyte‐to‐HDL‐cholesterol ratio as a prognostic marker in cardiovascular diseases. Journal of cellular physiology. 2018;233(12):9237-46.
26. Sari I, Karaoglu O, Can G, et al. Early ultrasonographic markers of atherosclerosis in patients with familial Mediterranean fever. Clinical rheumatology. 2007;26(9):1467-73.
27. Langevitz P, Livneh A, Neumann L, et al. Prevalence of ischemic heart disease in patients with familial Mediterranean fever. The Israel Medical Association journal: IMAJ. 2001;3(1):9-12.
28. Akdogan A, Calguneri M, Yavuz B, et al. Are familial Mediterranean fever (FMF) patients at increased risk for atherosclerosis? Impaired endothelial function and increased intima media thickness are found in FMF. Journal of the American College of Cardiology. 2006;48(11):2351-3.
29. Korkmaz C, Özdogan H, Kasapçopur Ö, et al. Acute phase response in familial Mediterranean fever. Annals of the rheumatic diseases. 2002;61(1):79-81.
30. Iacobellis G, Assael F, Ribaudo MC, et al. Epicardial fat from echocardiography: a new method for visceral adipose tissue prediction. Obesity research. 2003;11(2):304-10.