title: Cardiovascular autonomic dysfunction in familial Mediterranean fever.
abstract: OBJECTIVE
  To compare the hemodynamic responses to autonomic challenge evoked by upright tilt table testing in patients with familial Mediterranean fever (FMF).
  
  
  METHODS
  Forty consecutive patients with FMF and 25 age and sex matched healthy controls were evaluated using the head-up tilt test (HUTT). The main outcome measures were the values of blood pressure (BP) and heart rate (HR) recorded during recumbence and tilt. The endpoints of vasodepressor and cardioinhibitory reactions, orthostatic tachycardia, and postural tachycardia syndrome were recorded.
  
  
  RESULTS
  Patients with FMF exhibited significantly higher diastolic BP during supine and tilt measurements (p = 0.003 and 0.04, respectively). In response to tilt, patients showed significant increases in HR compared to healthy subjects (p = 0.02). Pathological endpoints on tilt were observed in the FMF group in 7 patients (17%) and in no controls. FMF severity, genotype, duration of illness, response to therapy, and associated amyloidosis did not correlate with pathological reactions on HUTT.
  
  
  CONCLUSIONS
  FMF patients exhibit an abnormal cardiovascular reactivity, which is clinically occult, but can be detected on autonomic challenge. The abnormal autonomic activity in FMF is similar to dysautonomia described in a variety of rheumatic disorders.
authors.affiliation: Department of Rheumatology and Zevulun Clinic, Bnai Zion Medical Center, Haifa, Israel.
authors.forename: Michael
authors.initials: M
authors.lastname: Rozenbaum
authors.forename: Jochanan E
authors.initials: JE
authors.lastname: Naschitz
authors.forename: Marina
authors.initials: M
authors.lastname: Yudashkin
authors.forename: Itzhak
authors.initials: I
authors.lastname: Rosner
authors.forename: Edmond
authors.initials: E
authors.lastname: Sabo
authors.forename: Naomi
authors.initials: N
authors.lastname: Shaviv
authors.forename: Luis
authors.initials: L
authors.lastname: Gaitini
authors.forename: Eli
authors.initials: E
authors.lastname: Zuckerman
authors.forename: Daniel
authors.initials: D
authors.lastname: Yeshurun
mesh_terms: D000293:Adolescent; D000328:Adult; D001342:Autonomic Nervous System Diseases / Q000175:diagnosis / Q000209:etiology*; D001794:Blood Pressure; D010505:Familial Mediterranean Fever / Q000150:complications*; D006339:Heart Rate; D006801:Humans; D011187:Posture; D018667:Tilt-Table Test