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Objective Cardiac involvement as pericarditis, myocarditis and valvular disease is common in juvenile idiopathic arthritis (JIA). However, there are few studies concerning systolic and diastolic functions of the left ventricle in children with JIA. P wave dispersion is a sign for the prediction of atrial fibrillation. A recent study found that rheumatoid arthritis patients had an abnormally high P wave duration and P wave dispersion, markers for supraventricular arrhythmogenicity. In this study, we aimed to evaluate P wave dispersion and its relation with diastolic dysfunction of the left ventricle in patients with JIA. Methods We performed electrocardiography and Doppler echocardiography on patients and controls. Maximum and minimum P wave duration were obtained from electrocardiographic measurements. P wave dispersion defined as the difference between maximum and minimum P wave duration was also calculated. Findings No statistically significant differences were found between the patients and controls in minimum, maximum P wave duration and P wave dispersion. Among the diastolic parameters in patients group, increased late flow velocity, decreased early flow velocity and prolonged isovolumic relaxation time reflected diastolic dysfunction. Conclusion During 12 months of follow-up, no supraventricular arrhythmias were documented in JIA with diastolic dysfunction. JIA with diastolic dysfunction has normal atrial conduction parameters and therefore seemingly do not have an increased risk of atrial fibrillation.

This study was conducted to determine the frequency of antinuclear antibodies (ANA) positivity and uveitis in our newly diagnosed juvenile idiopathic arthritis (JIA) patients classified according to International League Against Rheumatology (ILAR) classification criteria. Ninety-two girls and 106 boys, totally 198 children were enrolled in the study. of them 36 (18.2 percent) were found to be ANA positive. Chronic anterior uveitis was detected in 20 (10.1 percent) patients. ANA positivity was determined in 4 of the systemic JIA patients, in whom no uveitis had been detected. Twenty-five of 37 patients with oligoarticular JIA were ANA positive, in 10 of them uveitis was also diagnosed. ANA were positive in 3 of 34 patients with RF positive polyarticulat JIA, only one patient had positive ANA, and another one had uveitis. Nine patients were extended JIA and in none of them, ANA positivity or uveitis were present. Of 43 patients classified as enthesitis related arthritis (ERA), uveitis was diagnosed in 6 and there was no evidence of ANA positivity, but one had uveitis. We conclude that the incidence of ANA positivity and uveitis is low in Turkish children with JIA.

To assess aerobic fitness and exercise capacity in patients with juvenile idiopathic arthritis (JIA) and to determine subgroup differences.Thirty-four patients diagnosed with JIA and 21 healthy sedentary volunteers were studied. Aerobic fitness was determined by measuring peak power and peak oxygen uptake (VO2peak) during an incremental cycling test. The patient group consisted of systemic JIA (n = 8), polyarticular JIA (n = 13), oligoarticular JIA (n = 7), and enthesitis-related arthritis (ERA, n = 6). Results from different subgroups of JIA were compared to determine subgroup differences.All subjects tolerated maximal exercise testing well. The JIA group had lower aerobic fitness than controls. In our comparison of JIA subgroups, we found no significant differences in cardiopulmonary measures. The ERA group had higher aerobic capacity than other subgroups. There was no difference in exercise capacity between patients with active disease (n = 10) and those in remission (n = 24).We suggest that heterogeneity in VO2peak levels among JIA patients is due to subgroup differences. Exercise programs for improvement of aerobic fitness should be individualized or at least be modified according to different subgroups.

In this study bone status was assessed using a quantitative ultrasound (QUS) technique at the calcaneus in 141 healthy, prepubertal, Turkish schoolchildren (80 girls, 61 boys) aged 6-12 years. Broadband ultrasound attenuation (BUA, DB/MHz) was measured with a prototype pediatric contact bone analyzer (CUBA, McCue Ultrasonics Ltd). The relation of age, body weight and height to BUA was assessed. BUA increased linearly with age in boys and girls (R=0.448, p=0.0001 and R=0.382, p=0.002, respectively). BUA values in boys tended to be higher than in girls, reaching significance only at the age of seven years with a 95% confidence interval. In conclusion, the measurement of BUA in the calcaneus with QUS has important clinical implications in assessing bone mass in children. Further studies in not only healthy children but also in those with metabolic bone diseases would be helpful in order to evaluate its sensitivity and reproducibility.