title: Cardiovascular reactivity score for the assessment of dysautonomia in familial Mediterranean fever.
abstract: OBJECTIVE
  The aim of this study was to assess the presence of dysautonomia, as manifested in abnormal cardiovascular reactivity, in patients with familial Mediterranean fever (FMF).
  
  
  METHODS
  Fifty-five consecutive patients with FMF and 23 age- and sex-matched healthy controls were evaluated. Cardiovascular reactivity was studied: (1) using recordings of blood pressure (BP) and heart rate (HR) during 10 min of recumbence and 30 min of head-up tilt test to identify clinical endpoints and (2) during tilt-test, identifying parameters acting as independent predictors of FMF reactivity and enabling computation of a cardiovascular reactivity score (CVRS).
  
  
  RESULTS
  Clinically, vasovagal reaction, postural tachycardia syndrome, and/or orthostatic hypotension were observed in ten patients (18.1%). Utilizing a derived equation, the group average CVRS in FMF was 5.83+/-1.78 (healthy group -7.60+/-5.41) ( P=<0.0001). A CVRS of >3.25 was associated with FMF, with 98% sensitivity and 100% specificity.
  
  
  CONCLUSIONS
  A very high percentage of FMF patients exhibit abnormal cardiovascular reactivity which is clinically occult but can be detected on autonomic challenge and application of the CVRS.
mesh_terms: D000328:Adult; D001342:Autonomic Nervous System Diseases / Q000150:complications / Q000503:physiopathology*; D001794:Blood Pressure; D010505:Familial Mediterranean Fever / Q000150:complications / Q000503:physiopathology*; D005260:Female; D006339:Heart Rate; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D007024:Hypotension, Orthostatic / Q000209:etiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011187:Posture; D012680:Sensitivity and Specificity; D019462:Syncope, Vasovagal / Q000503:physiopathology; D013610:Tachycardia / Q000209:etiology / Q000503:physiopathology; D018667:Tilt-Table Test