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Normal autonomic nervous system responses in uncomplicated familial Mediterranean fever: a comparative case–control study

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Abstract

There is a paucity of knowledge regarding the autonomic nervous system function in patients with familial Mediterranean fever (FMF). Therefore, our aim was to evaluate autonomic responses in patients with FMF using complementary tests. The study groups included 33 patients with uncomplicated FMF and 39 control subjects. Autonomic function was evaluated by measuring responses to metronomic breathing, the Valsalva maneuver, and the Ewing maneuver. Autonomic parameters were computed from electrocardiograms with designated computer software. There were no statistically significant differences in any of the measured parameters of autonomic function between the patient and control group. The measured autonomic parameters of both groups were similar to those previously reported in healthy individuals. In conclusion, patients with FMF who did not develop amyloidosis due to continuous colchicine treatment appeared to have normal autonomic function, as reflected by the normal response to physiological autonomic stimuli.

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References

  1. Livneh A, Langevitz P (2000) Diagnostic and treatment concerns in familial Mediterranean fever. Baillières Best Pract Res Clin Rheumatol 14(3):477–498

    Article  PubMed  CAS  Google Scholar 

  2. Lidar M, Pras M, Langevitz P, Livneh A (2002) Thoracic and lung involvement in familial Mediterranean fever (FMF). Clin Chest Med 23(2):505–511

    Article  PubMed  Google Scholar 

  3. Sidi G, Shinar Y, Livneh A, Langevitz P, Pras M, Pras E (2000) Protracted febrile myalgia of familial Mediterranean fever. Mutation analysis and clinical correlations. Scand J Rheumatol 29(3):174–176

    Article  PubMed  CAS  Google Scholar 

  4. Touitou I, Sarkisian T, Medlej-Hashim M, Tunca M, Livneh A, Cattan D, Yalcinkaya F, Ozen S, Majeed H, Ozdogan H, Kastner D, Booth D, Ben-Chetrit E, Pugnere D, Michelon C, Seguret F, Gershoni-Baruch R (2007) Country as the primary risk factor for renal amyloidosis in familial Mediterranean fever. Arthritis Rheum 56(5):1706–1712

    Article  PubMed  Google Scholar 

  5. Gershoni-Baruch R, Brik R, Zacks N, Shinawi M, Lidar M, Livneh A (2003) The contribution of genotypes at the MEFV and SAA1 loci to amyloidosis and disease severity in patients with familial Mediterranean fever. Arthritis Rheum 48(4):1149–1155

    Article  PubMed  Google Scholar 

  6. Cefle A, Kamali S, Sayarlioglu M, Inanc M, Ocal L, Aral O, Konice M, Gul A (2005) A comparison of clinical findings of familial Mediterranean fever patients with and without amyloidosis. Rheumatol Int 25(6):442–446

    Article  PubMed  Google Scholar 

  7. Livneh A, Langevitz P, Zemer D, Zaks N, Kees S, Lidar T, Migdal A, Padeh S, Pras M (1997) Criteria for the diagnosis of familial Mediterranean fever. Arthritis Rheum 40(10):1879–1885

    Article  PubMed  CAS  Google Scholar 

  8. Shinar Y, Kuchuk I, Menasherow S, Kolet M, Lidar M, Langevitz P, Livneh A (2007) Unique spectrum of MEFV mutations in Iranian Jewish FMF patients—clinical and demographic significance. Rheumatology (Oxford) 46(11):1718–1722

    Article  CAS  Google Scholar 

  9. Stojanovich L, Milovanovich B, de Luka SR, Popovich-Kuzmanovich D, Bisenich V, Djukanovich B, Randjelovich T, Krotin M (2007) Cardiovascular autonomic dysfunction in systemic lupus, rheumatoid arthritis, primary Sjogren syndrome and other autoimmune diseases. Lupus 16(3):181–185

    PubMed  CAS  Google Scholar 

  10. Maule S, Quadri R, Mirante D, Pellerito RA, Marucco E, Marinone C, Vergani D, Chiandussi L, Zanone MM (1997) Autonomic nervous dysfunction in systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA): possible pathogenic role of autoantibodies to autonomic nervous structures. Clin Exp Immunol 110(3):423–427

    Article  PubMed  CAS  Google Scholar 

  11. Rozenbaum M, Naschitz JE, Yudashkin M, Rosner I, Sabo E, Shaviv N, Gaitini L, Zuckerman E, Yeshurun D (2002) Cardiovascular autonomic dysfunction in familial Mediterranean fever. J Rheumatol 29(5):987–989

    PubMed  Google Scholar 

  12. Rozenbaum M, Naschitz JE, Yudashkin M, Sabo E, Shaviv N, Gaitini L, Zuckerman E, Yeshurun D, Rosner I (2004) Cardiovascular reactivity score for the assessment of dysautonomia in familial Mediterranean fever. Rheumatol Int 24(3):147–152

    Article  PubMed  Google Scholar 

  13. England JD, Gronseth GS, Franklin G, Carter GT, Kinsella LJ, Cohen JA, Asbury AK, Szigeti K, Lupski JR, Latov N, Lewis RA, Low PA, Fisher MA, Herrmann DN, Howard JF Jr, Lauria G, Miller RG, Polydefkis M, Sumner AJ (2009) Practice parameter: evaluation of distal symmetric polyneuropathy: role of autonomic testing, nerve biopsy, and skin biopsy (an evidence-based review). Report of the American Academy of Neurology, American Association of Neuromuscular and Electrodiagnostic Medicine, and American Academy of Physical Medicine and Rehabilitation. Neurology 72(2):177–184

    Article  PubMed  CAS  Google Scholar 

  14. Nussinovitch N, Livneh A, Katz K, Langevitz P, Feld O, Nussinovitch M, Volovitz B, Lidar M, Nussinovitch U (2011) Heart rate variability in familial Mediterranean fever. Rheumatol Int 31(1):39–43

    Article  PubMed  Google Scholar 

  15. Hilz MJ, Dutsch M (2006) Quantitative studies of autonomic function. Muscle Nerve 33(1):6–20

    Article  PubMed  Google Scholar 

  16. Nussinovitch U, Katz U, Nussinovitch M, Nussinovitch N (2009) Deep breath test for evaluation of autonomic nervous system dysfunction in familial dysautonomia. Isr Med Assoc J 11(10):615–618

    PubMed  Google Scholar 

  17. Freeman R (2006) Assessment of cardiovascular autonomic function. Clin Neurophysiol 117(4):716–730

    Article  PubMed  Google Scholar 

  18. Melo RC, Santos MD, Silva E, Quiterio RJ, Moreno MA, Reis MS, Verzola IA, Oliveira L, Martins LE, Gallo-Junior L, Catai AM (2005) Effects of age and physical activity on the autonomic control of heart rate in healthy men. Braz J Med Biol Res 38(9):1331–1338

    Article  PubMed  CAS  Google Scholar 

  19. Malliani A, Pagani M, Lombardi F, Cerutti S (1991) Cardiovascular neural regulation explored in the frequency domain. Circulation 84(2):482–492

    PubMed  CAS  Google Scholar 

  20. Pomeranz B, Macaulay RJ, Caudill MA, Kutz I, Adam D, Gordon D, Kilborn KM, Barger AC, Shannon DC, Cohen RJ et al (1985) Assessment of autonomic function in humans by heart rate spectral analysis. Am J Physiol 248(1 Pt 2):H151–H153

    PubMed  CAS  Google Scholar 

  21. Stein PK, Bosner MS, Kleiger RE, Conger BM (1994) Heart rate variability: a measure of cardiac autonomic tone. Am Heart J 127(5):1376–1381

    Article  PubMed  CAS  Google Scholar 

  22. Task Force of the European Society of Cardiology, North American Society of Pacing and Electrophysiology (1996) Heart rate variability: standards of measurement, physiological interpretation and clinical use. Circulation 93(5):1043–1065

    Article  Google Scholar 

  23. Pal GK, Velkumary S, Madanmohan (2004) Effect of short-term practice of breathing exercises on autonomic functions in normal human volunteers. Indian J Med Res 120(2):115–121

    PubMed  CAS  Google Scholar 

  24. Lluch I, Hernández A, Real JT, Morillas C, Tenés S, Sánchez C, Ascaso JF (1998) Cardiovascular autonomic neuropathy in type 1 diabetic patients with and without peripheral neuropathy. Diabetes Res Clin Pract 42(1):35–40

    Google Scholar 

  25. Lawrence GP, Home PD, Murray A (1992) Repeatability of measurements and sources of variability in tests of cardiovascular autonomic function. Br Heart J 68(2):205–11

    Google Scholar 

  26. Vazeou A, Papadopoulou A, Miha M, Drakatos A, Georgacopoulos D (2008) Cardiovascular impairment in children, adolescents, and young adults with type 1 diabetes mellitus (T1DM). Eur J Pediatr 167(8):877–884

    Google Scholar 

  27. Baldwa VS, Ewing DJ (1977) Heart rate response to Valsalva manoeuvre. Reproducibility in normals, and relation to variation in resting heart rate in diabetics. Br Heart J 39(6):641–644

    Google Scholar 

  28. Yong VK, Umapathi T, Aung T, Tan NC, Lee JJ, Liew GC, Yip CC, Foster PJ, Chew PT (2004) Systemic autonomic function in subjects with primary angle-closure glaucoma: a comparative study of symptomatic and asymptomatic disease presentation. Clin Experiment Ophthalmol 32(2):137–141

    Google Scholar 

  29. Yakinci C, Müngen B, Durmaz Y, Balbay D, Karabiber H (1997) Autonomic nervous system functions in children with nocturnal enuresis. Brain Dev 19(7):485–487

    Google Scholar 

  30. Gutrecht JA (1992) Autonomic cardiovascular reflexes in progressive supranuclear palsy. J Auton Nerv Syst 39(1):29–35

    Google Scholar 

  31. Nussinovitch U, Nussinovitch N, Nussinovitch M, Volovitz B, Feld O, Ben-Zvi I, Livneh A (2011) QT dispersion in amyloidosis due to familial Mediterranean fever. Rheumatol Int

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Acknowledgments

We wish to thank Gloria Ginzach, Hanni Penn, and Phyllis Curchack Kornspan for their editorial assistance. This study is dedicated to the memory of Haim Gueron.

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Authors and Affiliations

  1. The Heller Institute of Medical Research, and Department of Medicine F, Sheba Medical Center, Tel Hashomer, Israel, 52621

    Udi Nussinovitch

  2. The Heller Institute of Medical Research, Chaim Sheba Medical Center, Tel Hashomer, Israel

    Avi Livneh, Pnina Langevitz, Olga Feld & Merav Lidar

  3. Department of Internal Medicine F, Chaim Sheba Medical Center, Tel Hashomer, Israel

    Avi Livneh, Pnina Langevitz, Olga Feld & Merav Lidar

  4. Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

    Udi Nussinovitch, Avi Livneh, Keren Kaminer, Pnina Langevitz, Olga Feld, Moshe Nussinovitch, Benjamin Volovitz & Merav Lidar

  5. Department of Pediatrics C, Schneider Children’s Medical Center of Israel, Petach Tikva, Israel

    Moshe Nussinovitch & Benjamin Volovitz

  6. Hypertension Unit and Department of Internal Medicine D, Sheba Medical Center, Tel Hashomer, Israel

    Naomi Nussinovitch

Authors
  1. Udi Nussinovitch
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  2. Avi Livneh
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  3. Keren Kaminer
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  4. Pnina Langevitz
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  5. Olga Feld
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  6. Moshe Nussinovitch
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  7. Benjamin Volovitz
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  8. Merav Lidar
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  9. Naomi Nussinovitch
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Corresponding author

Correspondence to Udi Nussinovitch.

Additional information

Udi Nussinovitch and Avi Livneh contributed equally to this paper.

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

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Nussinovitch, U., Livneh, A., Kaminer, K. et al. Normal autonomic nervous system responses in uncomplicated familial Mediterranean fever: a comparative case–control study. Clin Rheumatol 30, 1347–1351 (2011). https://doi.org/10.1007/s10067-011-1759-5

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  • DOI: https://doi.org/10.1007/s10067-011-1759-5

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