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Colchicine’s Effects on Electrocardiographic Parameters in Newly Diagnosed Familial Mediterranean Fever Patients

Colchicine may have Favourable Effects on Parameters Related to Ventricular Arrhythmias in New Diagnosed Familial Mediterranean Fever

Wirkungen von Colchizin auf EKG-Parameter bei Patienten mit neu diagnostiziertem familiärem Mittelmeerfieber

Positive Wirkungen von Colchizin auf Parameter ventrikulärer Arrhythmien bei neu diagnostiziertem familiärem Mittelmeerfieber

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Abstract

Objective

Colchicine may prevent both recurrent serositis attacks and secondary amyloidosis in familial Mediterranean fever (FMF). Furthermore, colchicine may decrease the frequency of atrial fibrillation in some groups of patients without FMF. However, there is no study that evaluates the effect of colchicine on arrhythmogenic electrocardiographic indices in FMF. In this study, we evaluated the impact of 1 year of colchicine treatment on atrial and ventricular arrhythmogenic electrocardiographic (ECG) parameters in newly diagnosed FMF patients.

Materials and methods

We enrolled 28 newly diagnosed FMF (20 female, mean age 31.4 ± 8.2 years) patients who fulfilled the modified Tel Hashomer criteria. Electrocardiographic, demographic and laboratory parameters were obtained at the first visit and at the end of the 1‑year colchicine treatment. Herein, we assessed P wave dispersion (Pd) for atrial arrhythmia risk and peak-to-end interval of T wave (Tp-E), Tp-E/QT, Tp-E/QTc values for ventricular arrhythmia risk.

Results

Colchicine treatment significantly decreased Tp-E and Tp-E/QT values (p = 0.02 and p = 0.01, respectively) by the end of the 1‑year treatment. However, Pd values did not change with treatment.

Conclusion

Colchicine treatment may have a favourable effect on ventricular repolarisation indices that relate to ventricular arrhythmia and sudden death.

Zusammenfassung

Ziel der Arbeit

Mit Colchizin lassen sich möglicherweise sowohl rezidivierende Serositisschübe als auch die sekundäre Amyloidose bei familiärem Mittelmeerfieber (FMF) verhindern. Außerdem kann Colchizin die Häufigkeit von Vorhofflimmern bei einigen Gruppen von Patienten ohne FMF senken. Jedoch liegt bisher keine Studie zur Wirkung von Colchizin auf arrhythmogene elektrokardiographische (EKG-)Hinweise bei FMF vor. In der vorliegenden Studie untersuchten die Autoren den Einfluss einer einjährigen Colchizinbehandlung auf atriale und ventrikuläre arrhythmogene EKG-Parameter bei Patienten mit neu diagnostiziertem FMF.

Material und Methoden

Dazu wurden 28 Patienten mit neu diagnostiziertem FMF (20 w., Durchschnittsalter: 31,4 ± 8,2 Jahre) in die Studie einbezogen, die die modifizierten Tel-Hashomer-Kriterien erfüllten. Elektrokardiographische, demografische und Laborparameter wurden bei der Erstvorstellung und am Ende der einjährigen Behandlung mit Colchizin erhoben. Dabei wurde die P‑Wellen-Dispersion (Pd) hinsichtlich des Risikos atrialer Arrhythmien und das Intervall zwischen Spitze und Ende der T‑Welle („peak-to-end interval of T wave“, Tp-E) sowie das Verhältnis von Tp-E zum QT-Intervall (Tp-E/QT) und zum frequenzkorrigierten QT-Intervall (Tp-E/QTc) hinsichtlich des Risikos ventrikulärer Arrhythmien untersucht.

Ergebnisse

Unter Colchizinbehandlung erwiesen sich der Tp-E- und der Tp-E/QT-Wert am Ende der einjährigen Therapie als signifikant niedriger (p = 0,02 bzw. p = 0,01). Allerdings veränderten sich die Pd-Werte unter der Therapie nicht.

Schlussfolgerung

Colchizin hat möglicherweise positive Wirkungen auf ventrikuläre Repolarisationsparameter, die in Zusammenhang mit ventrikulären Arrhythmien und plötzlichem Herztod stehen.

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References

  1. Acar G, Akcay A, Sayarlioglu M et al (2009) Assessment of atrial conduction time in patients with familial Mediterranean fever. Pacing Clin Electrophysiol 32:308–313

    Article  Google Scholar 

  2. Ahbap E, Sakaci T, Kara E et al (2015) Familial Mediterranean fever is associated with abnormal ventricular repolarization indices. Rev Med Chil 143:1560–1568

    Article  Google Scholar 

  3. Akcay A, Acar G, Sayarlioglu M et al (2009) QT dispersion and transmural dispersion of repolarization in patients with familial Mediterranean fever. Mod Rheumatol 19:550–555

    Article  Google Scholar 

  4. Arslan D, Oran B, Yazilitas F et al (2013) P‑wave duration and dispersion in children with uncomplicated familial Mediterranean fever. Mod Rheumatol 23:1166–1171

    Article  Google Scholar 

  5. Aytemir K, Ozer N, Atalar E et al (2000) P wave dispersion on 12-lead electrocardiography in patients with paroxysmal atrial fibrillation. Pacing Clin Electrophysiol 23:1109–1112

    Article  CAS  Google Scholar 

  6. Castro Hevia J, Antzelevitch C, Tornes Barzaga F et al (2006) Tpeak-Tend and Tpeak-Tend dispersion as risk factors for ventricular tachycardia/ventricular fibrillation in patients with the Brugada syndrome. J Am Coll Cardiol 47:1828–1834

    Article  Google Scholar 

  7. Dabestani A, Noble LM, Child JS et al (1982) Pericardial disease in familial Mediterranean fever: An echocardiographic study. Chest 81:592–595

    Article  CAS  Google Scholar 

  8. Day CP, Mccomb JM, Campbell RW (1990) QT dispersion: An indication of arrhythmia risk in patients with long QT intervals. Br Heart J 63:342–344

    Article  CAS  Google Scholar 

  9. Deftereos S, Giannopoulos G, Kossyvakis C et al (2012) Colchicine for prevention of early atrial fibrillation recurrence after pulmonary vein isolation: A randomized controlled study. J Am Coll Cardiol 60:1790–1796

    Article  CAS  Google Scholar 

  10. Giese A, Ornek A, Kurucay M et al (2014) P wave dispersion and QT dispersion in adult Turkish migrants with familial mediterranean fever living in Germany. Int J Med Sci 11:1140–1146

    Article  Google Scholar 

  11. Gupta P, Patel C, Patel H et al (2008) T(p-e)/QT ratio as an index of arrhythmogenesis. J Electrocardiol 41:567–574

    Article  Google Scholar 

  12. Hu YF, Chen YJ, Lin YJ et al (2015) Inflammation and the pathogenesis of atrial fibrillation. Nat Rev Cardiol 12:230–243

    Article  CAS  Google Scholar 

  13. Livneh A, Langevitz P, Zemer D et al (1997) Criteria for the diagnosis of familial Mediterranean fever. Arthritis Rheum 40:1879–1885

    Article  CAS  Google Scholar 

  14. Manna R, Cerquaglia C, Curigliano V et al (2009) Clinical features of familial Mediterranean fever: An Italian overview. Eur Rev Med Pharmacol Sci 13(Suppl 1):51–53

    PubMed  Google Scholar 

  15. Masoud S, Lim PB, Kitas GD et al (2017) Sudden cardiac death in patients with rheumatoid arthritis. World J Cardiol 9:562–573

    Article  Google Scholar 

  16. Nussinovitch N, Livneh A, Katz K et al (2010) QT dispersion in uncomplicated familial Mediterranean fever. Clin Rheumatol 29:1353–1356

    Article  Google Scholar 

  17. Nussinovitch U, Kaminer K, Nussinovitch M et al (2012) QT interval variability in familial Mediterranean fever: A study in colchicine-responsive and colchicine-resistant patients. Clin Rheumatol 31:795–799

    Article  Google Scholar 

  18. Nussinovitch U, Livneh A, Nussinovitch M et al (2011) P‑wave dispersion in systemic AA amyloidosis of familial Mediterranean fever. Clin Rheumatol 30:1295–1298

    Article  Google Scholar 

  19. Nussinovitch U, Livneh A, Volovitz B et al (2012) Normal QT dispersion in colchicine-resistant familial Mediterranean fever (FMF). Clin Rheumatol 31:1093–1096

    Article  Google Scholar 

  20. Nussinovitch U, Nussinovitch N, Nussinovitch M et al (2012) QT dispersion in amyloidosis due to familial Mediterranean fever. Rheumatol Int 32:1945–1948

    Article  Google Scholar 

  21. Okutucu S, Aytemir K, Oto A (2016) P‑wave dispersion: What we know till now? JRSM Cardiovasc Dis. https://doi.org/10.1177/2048004016639443

    Article  PubMed  PubMed Central  Google Scholar 

  22. Onen F (2006) Familial Mediterranean fever. Rheumatol Int 26:489–496

    Article  Google Scholar 

  23. Shimizu M, Ino H, Okeie K et al (2002) T‑peak to T‑end interval may be a better predictor of high-risk patients with hypertrophic cardiomyopathy associated with a cardiac troponin I mutation than QT dispersion. Clin Cardiol 25:335–339

    Article  Google Scholar 

  24. Topal F, Tanindi A, Kurtoglu HG et al (2011) QT dispersion is not increased in familial Mediterranean fever. J Int Med Res 39:2006–2011

    Article  CAS  Google Scholar 

  25. Topilski I, Rogowski O, Rosso R et al (2007) The morphology of the QT interval predicts torsade de pointes during acquired bradyarrhythmias. J Am Coll Cardiol 49:320–328

    Article  Google Scholar 

  26. Wang M, Li S, Zhou X et al (2017) Increased inflammation promotes ventricular arrhythmia through aggravating left stellate ganglion remodeling in a canine ischemia model. Int J Cardiol 248:286–293

    Article  Google Scholar 

  27. Yalta T, Yalta K (2018) Systemic inflammation and arrhythmogenesis: A review of mechanistic and clinical perspectives. Angiology 69:288–296

    Article  Google Scholar 

  28. Zhao X, Xie Z, Chu Y et al (2012) Association between Tp-e/QT ratio and prognosis in patients undergoing primary percutaneous coronary intervention for ST-segment elevation myocardial infarction. Clin Cardiol 35:559–564

    Article  Google Scholar 

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Authors and Affiliations

  1. Kartal Dr. Lutfi Kirdar Training and Research Hospital, Department of Internal Medicine, University of Health Sciences, Istanbul, Turkey

    Aslı Gozek Ocal

  2. Kosuyolu Kartal Heart Training and Research Hospital, Department of Cardiology, University of Health Sciences, Istanbul, Turkey

    Lutfi Ocal, Ayhan Kup & Hayati Eren

  3. Kartal Dr. Lutfi Kirdar Training and Research Hospital, Department of Rheumatology, University of Health Sciences, 34680, Kartal, Istanbul, Turkey

    Mehmet Engin Tezcan M.D.

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  1. Aslı Gozek Ocal
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  2. Lutfi Ocal
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Correspondence to Mehmet Engin Tezcan M.D..

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Conflict of interest

A.G. Ocal, L. Ocal, A. Kup, H. Eren and M.E. Tezcan declare that they have no competing interests.

All procedures performed in studies involving human participants or on human tissue were in accordance with the ethical standards of the institutional and/or national research committee and with the 1975 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

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U. Müller-Ladner, Bad Nauheim

U. Lange, Bad Nauheim

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Ocal, A.G., Ocal, L., Kup, A. et al. Colchicine’s Effects on Electrocardiographic Parameters in Newly Diagnosed Familial Mediterranean Fever Patients. Z Rheumatol 79, 210–215 (2020). https://doi.org/10.1007/s00393-019-0642-7

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  • DOI: https://doi.org/10.1007/s00393-019-0642-7

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