Deteriorated Systolic Blood Pressure Recovery and Heart Rate Recovery After Graded Exercise in Children With Familial Mediterranean Fever

Havva EVRENGÜL1, Selçuk YÜKSEL2, Mustafa DOĞAN3, Dolunay GÜRSES3, Harun EVRENGÜL4

1Department of Pediatric Nephrology, Medical Faculty of Pamukkale University, Denizli, Turkey
2Department of Pediatric Rheumatology, Medical Faculty of Pamukkale University, Denizli, Turkey
3Department of Pediatric Cardiology, Medical Faculty of Pamukkale University, Denizli, Turkey
4Department of Cardiology, Medical Faculty of Pamukkale University, Denizli, Turkey

Keywords: Autonomic dysfunction; Familial Mediterranean fever; heart rate recovery; systolic blood pressure recovery

Abstract

Objectives: This study aims to investigate if cardiac involvement may occur in children with familial Mediterranean fever (FMF) without cardiovascular symptoms by using heart rate recovery (HRR) and systolic blood pressure recovery (SBPR) parameters.
Patients and methods: A total of 50 FMF patients (26 males, 24 females; mean age 151±33.4 month; range 60 to 216 month) and 30 healthy controls (18 males, 12 females; mean age 143±43.9 month; range 84 to 228 month) were included in the study. All patients were evaluated by echocardiography. All patients underwent a maximal graded exercise stress test. HRR and SBPR parameters were calculated.
Results: There was a significant decrease in HRR1 value in FMF group (p=0.03). SBPR1 and SPBR2 values were higher in FMF group compared to control group (0.96±0.12 vs 0.88±0.12 and 0.95±0.09 vs 0.91±0.11, respectively); and the high SBPR1 value was statistically significant (p=0.02). FMF presence had a negative correlation with HRR1 (r= -0.26, p=0.03) and a positive correlation with SBPR1 (r=0.29, p=0.02). There was a negative correlation of M694V homozygous mutation with HRR1 and HRR2 values (r= -0.43, p=0.004, r=-0.42, p=0.005).
Conclusion: Cardiac involvement may occur in FMF patients without cardiovascular symptoms. Impaired SBPR and decreased HRR response may indicate increased cardiovascular risk in these patients despite normal exercise stress test results.

Conflict of Interest

The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.

Financial Disclosure

The authors received no financial support for the research and/or authorship of this article.