Left ventricular and left atrial strain characteristics in patients with familial mediterranean fever receiving long-term colchicine therapy

Abstract

Background: Familial Mediterranean fever (FMF) is a chronic autoinflammatory disorder characterized by sustained systemic inflammation that may affect cardiac structure and function. Colchicine is the cornerstone of FMF therapy and has cardiovascular benefits in inflammatory settings. Methods: This cross-sectional study enrolled 106 participants: 53 patients with FMF receiving long-term colchicine therapy and 53 age- and sex-matched controls. Participants underwent transthoracic echocardiography with speckle-tracking imaging. Conventional parameters and strain-derived indices of the left ventricular (LV) and left atrial (LA) function were assessed. Correlation analyses and multivariable linear regression models were used to evaluate the association between FMF presence and cardiac strain parameters. Results: The LV ejection fractions were comparable between the groups. The FMF group showed thinner ventricular walls and larger chamber dimensions than the control group. Patients with FMF exhibited higher LA reservoir strain, while conduit and contractile atrial contributions were reduced, as shown by lower passive and active emptying fractions and reduced LA ejection fraction. LA volumes and stiffness indices were lower in the FMF group, indicating smaller and more compliant atrial structures. Left ventricular global longitudinal strain (LVGLS) was more negative in patients with FMF, indicating preserved LV longitudinal systolic function. FMF was independently associated with LVGLS and LA strain parameters after adjusting for cardiovascular risk factors. Conclusions: In patients with FMF receiving long-term colchicine therapy, cardiac strain imaging showed preserved LV longitudinal function and distinct LA mechanics with preserved reservoir strain but reduced conduit and contractile function. Strain echocardiography may provide insights into cardiac involvement in well-controlled FMF, although prospective studies are needed to clarify the clinical significance of these findings.