Assessment of Atrial Conduction Time in Patients with Familial Mediterranean Fever

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.