Impact of Colchicine Therapy on Ventriculoarterial Coupling in Familial Mediterranean Fever: A Cross-Sectional Study

<b>Background:</b> Familial Mediterranean Fever (FMF) is a chronic autoinflammatory disorder that is characterized by increased arterial stiffness and subtle cardiovascular dysfunction. Colchicine remains the mainstay of treatment and may provide vascular benefits that extend beyond its anti-inflammatory effects. However, the association between colchicine therapy and ventriculoarterial coupling (VAC), a hemodynamic marker of cardiovascular efficiency, has not been previously studied. <b>Methods:</b> In this cross-sectional study, 97 patients with FMF receiving colchicine therapy for at least one year and 81 colchicine-naive individuals without FMF were consecutively enrolled from a tertiary rheumatology outpatient clinic. The VAC was evaluated using the Chen method, calculated as the ratio of arterial elastance (Ea) to end-systolic elastance (Es), based on echocardiographic measurements and noninvasive brachial blood pressure. Correlation analyses and stepwise multivariate linear regression analyses were performed to identify independent predictors of VAC. <b>Results:</b> Patients with FMF demonstrated significantly lower VAC values compared to controls (1.23 ± 0.34 vs. 1.40 ± 0.57; <i>p</i> = 0.001). The colchicine dose was inversely correlated with VAC (r = -0.243; <i>p</i> = 0.001) and remained an independent predictor in multivariate analysis (β = -0.186, <i>p</i> = 0.018). Beta-blocker use was positively associated with VAC (β = 0.194, <i>p</i> = 0.014), whereas female sex showed a borderline inverse association. <b>Conclusions:</b> Colchicine use in patients with FMF was associated with more favorable VAC in a dose-dependent manner. These findings suggest that colchicine may exert cardiovascular effects beyond the control of inflammation. VAC may be a useful noninvasive marker for assessing vascular-ventricular interactions in FMF.