Research Article
BibTex RIS Cite

The Importance of Electrocardiographic Evaluation in Patients with Celiac Disease

Year 2023, Volume: 45 Issue: 3, 425 - 430, 23.05.2023
https://doi.org/10.20515/otd.1230679

Abstract

At the present study, study we aimed to analyze the risk factors for cardiac arrhythmias related disease factors by evaluating some ventricular repolarization parameters in the electrocardiographic (ECG) evaluation of CD. The study was conducted retrospectively from the files of the patients. The ECG evaluation of 63 patients aged 5-18 years diagnosis with CD and 63 healthy control group in Adana City Training and Research Hospital, between 01.2018-11.2022. Patients who were taking any drugs, who had a chronic disease and/or abnormal tests (vitamin B12, folate, tissue transglutaminase, anti-endomysium antibody titers) were excluded from the study. The ventricular repolarization parameters (QT interval, QTc interval, QT dispersion, QTc dispersion, Tp-e interval, Tp-e/QT, Tp-e/QTc) analyzed on ECG and compared both groups. The measured ventricular repolarization parameters of the patients and control groups were not statistically different. From the ECG data, it was found that the QTc min value was higher in patients diagnosed before 5 years old than the patients diagnosed after 8 years old. While the QTc dispersion was higher in patients diagnosed after 8 years old than the patients with an age at diagnosed before 5 years old. It was found that the values of QT min, QT max, and QT in the ECG were influenced by the duration of the disease and significantly high related with the disease duration (more than 5 years). We found that QTc dispersion was higher in patients with a later diagnosis. This suggests that cardiac involvement is also increased in patients with a late diagnosis.

Supporting Institution

No one

References

  • 1. Rewers M. Epidemiology of celiac disease: What are the prevalence, incidence, and progression of celiac disease? Gastroenterology. 2005;128:47-51.
  • 2. Van Kalleveen MW, de Meij T, Plötz FB. Clinical spectrum of paediatric coeliac disease: a 10-year single-centre experience. Eur J Pediatr. 2018;177:593-602.
  • 3. Kayali S, Selbuz S. Assessment of Autonomic Nervous System in Children with Celiac Disease: A Heart Rate Variability Study. Indian Pediatr. 2020;57:719-22.
  • 4. Gawałko M, Balsam P, Lodziński P, Grabowski M, Krzowski B, Opolski G, et al. Cardiac Arrhythmias in Autoimmune Diseases. Circ J. 2020;84:685-94.
  • 5. Sategna‐Guidetti C, Franco E, Martini S, Bobbio M. Binding by serum IgA antibodies from patients with coeliac disease to monkey heart tissue. Scandinavian Journal of Gastroenterology. 2004;39:540-3.
  • 6. Myrmel GMS, Lunde T, Saeed S. Clinical spectrum of Celiac disease from a cardiology perspective. Pak J Med Sci. 2022;38:782-4.
  • 7. Frustaci A, Cuoco L, Chimenti C, Pieroni M, Fioravanti G, Gentiloni N, et al. Celiac Disease Associated With Autoimmune Myocarditis. Circulation. 2002;105:2611-8.
  • 8. Shahramian I, Dehghani SM, Haghighat M, Noori NM, Teimouri A, Sharafi E, et al. Serological Evaluation of Celiac Disease in Children with Congenital Heart Defect; A Case Control Study. Middle East J Dig Dis. 2015;7:98-103.
  • 9. Mannarino S, Santacesaria S, Raso I, Fini G, Pozzi E, Cocuccio C, et al. Atrioventricular Block in Celiac Disease: An Unusual Clinical Presentation in a Child. A Case-Based Review. Children. 2022;9:1627.
  • 10. Samy L, Barkun A, Huynh T. Cardiac syncope in a woman with undiagnosed celiac disease. CMAJ. 2017;189:365-7.
  • 11. Corazza GR, Frisoni M, Filipponi C, Gullo L, Poggi VM, Gasbarrini G. Investigation of QT interval in adult coeliac disease. BMJ. 1992;304:1285.
  • 12. Fathy A, Abo-Haded H, Al-Ahmadi N, El-Sonbaty M. Cardiac functions assessment in children with celiac disease and its correlation with the degree of mucosal injury: Doppler tissue imaging study. Saudi J Gastroenterol. 2016;22:441-7.
  • 13. Gupta P, Patel C, Patel H, Narayanaswamy S, Malhotra B, Green JT, et al. Tp-e/QT ratio as an index of arrhythmogenesis. Journal of Electrocardiology. 2008;41:567-74.
  • 14. Demirtaş K, Yayla Ç, Yüksel M, B Açar, S Ünal, A G Ertem, et al. Tp-e interval and Tp-e/QT ratio in patients with celiac disease. Revista Clínica Española. 2017;217:439-45.
  • 15. Demircan T, Çağan Appak Y, Baran M, Aksoy B, Güven B, Narin N, et al. Does Celiac Disease Effect Electrocardiographic Markers of Arrhythmic Events in Children? JPR. 2021;8:7-13.
  • 16. Birinci H, Yolcu C, Dogan G, Basaran MK, Elevli M. Are Tp-e interval and QT dispersion values important in children with coeliac disease? Cardiol Young. 2022;24:1-6.
  • 17. Aydin Şahi̇n D, Şahi̇n Y. Evaluation of Cardiac Functions and Electrocardiogram Parameters in Children with Celiac Disease. Osmangazi Journal of Medıcıne. Erişim adresi: https://dergipark.org.tr/en/doi/10.20515/otd.924868
  • 18. Huang J. Assessment of the causal association between celiac disease and cardiovascular diseases. Front Cardiovasc Med. 2022;9:1017209.

Çölyak Hastalarında Elektrokardiyografik Değerlendirmenin Önemi

Year 2023, Volume: 45 Issue: 3, 425 - 430, 23.05.2023
https://doi.org/10.20515/otd.1230679

Abstract

Bu çalışmada Çölyak Hastalığı (ÇH)’ında elektrokardiografik (EKG) değerlendirmede bazı ventriküler repolarizasyon parametrelerini değerlendirerek aritmi risk faktörleri ve bununla ilişkili hastalık faktörlerini değerlendirmek amaçlanmıştır. Çalışma Adana Şehir Eğitim ve Araştırma Hastanesi Çocuk Gastroenteroloji Polikliniğin’de Ocak 2018 ve Kasım 2022 yılları arasında ÇH tanısı ile takip edilen, 5-18 yaş arası, 63 hastanın, retrospektif olarak dosyalarında var olan EKG verilerinin değerlendirmesi ile yapılmıştır. Çalışmaya 63 sağlıklı çocuk kontrol grubu olarak dahil edildi. Kardiyak fonksiyon üzerine etkisi olan ilaç kullanan, kronik hastalığı olan (diabet, tiroidit, Kistik Fibroz gibi) ve kan parametrelerinde bozukluk (B12 vitamin düzeyi, folat, doku transglutaminaz antikoru, anti endomisyum antikoru titre düzeyi) olan hastalar çalışma dışı bırakıldı. EKG’de ventriküler repolarizasyon parametreleri (QT aralığı, QTc aralığı, QT disperisyonu, QTc dispersion, Tp-e aralığı, Tp-e / QT, Tp-e / QTc) bakılarak hasta ve kontrol grupları arasında karşılaştırıldı. Hasta ve kontrol grubunun ölçülen ventriküler repolarizasyon parametre arasında istatistiksel olarak anlamlı fark yoktu. QTc dispersiyonun tanı yaşından etkilendiği görüldü. Buna göre QTc min değeri ilk tanı anındaki yaşı <5 olan hastalarda ilk tanı aldığı yaşı >8 olan hastalara göre daha yüksek bulunurken, QTc dispersiyonu ilk tanı anındaki yaşı >8 olanlarda ilk tanı anındaki yaşı <5 olanlara göre daha yüksek bulunmuştur. EKG’deki QT min, QT max ve QT değerlerinin hastalık süresinden etkilendiği görüldü. Hastalık süresi >5 yıl olan hastalarda diğerlerinden daha yüksek bulundu.Biz çalışmamızda tanı yaşı büyük olan hastalarda QTc dispersiyonunun artmış olduğunu bulduk. Bu bize geç tanı alan hastalarda kardiyolojik etkilenmenin de artmış olduğunu ortaya koymaktadır.

References

  • 1. Rewers M. Epidemiology of celiac disease: What are the prevalence, incidence, and progression of celiac disease? Gastroenterology. 2005;128:47-51.
  • 2. Van Kalleveen MW, de Meij T, Plötz FB. Clinical spectrum of paediatric coeliac disease: a 10-year single-centre experience. Eur J Pediatr. 2018;177:593-602.
  • 3. Kayali S, Selbuz S. Assessment of Autonomic Nervous System in Children with Celiac Disease: A Heart Rate Variability Study. Indian Pediatr. 2020;57:719-22.
  • 4. Gawałko M, Balsam P, Lodziński P, Grabowski M, Krzowski B, Opolski G, et al. Cardiac Arrhythmias in Autoimmune Diseases. Circ J. 2020;84:685-94.
  • 5. Sategna‐Guidetti C, Franco E, Martini S, Bobbio M. Binding by serum IgA antibodies from patients with coeliac disease to monkey heart tissue. Scandinavian Journal of Gastroenterology. 2004;39:540-3.
  • 6. Myrmel GMS, Lunde T, Saeed S. Clinical spectrum of Celiac disease from a cardiology perspective. Pak J Med Sci. 2022;38:782-4.
  • 7. Frustaci A, Cuoco L, Chimenti C, Pieroni M, Fioravanti G, Gentiloni N, et al. Celiac Disease Associated With Autoimmune Myocarditis. Circulation. 2002;105:2611-8.
  • 8. Shahramian I, Dehghani SM, Haghighat M, Noori NM, Teimouri A, Sharafi E, et al. Serological Evaluation of Celiac Disease in Children with Congenital Heart Defect; A Case Control Study. Middle East J Dig Dis. 2015;7:98-103.
  • 9. Mannarino S, Santacesaria S, Raso I, Fini G, Pozzi E, Cocuccio C, et al. Atrioventricular Block in Celiac Disease: An Unusual Clinical Presentation in a Child. A Case-Based Review. Children. 2022;9:1627.
  • 10. Samy L, Barkun A, Huynh T. Cardiac syncope in a woman with undiagnosed celiac disease. CMAJ. 2017;189:365-7.
  • 11. Corazza GR, Frisoni M, Filipponi C, Gullo L, Poggi VM, Gasbarrini G. Investigation of QT interval in adult coeliac disease. BMJ. 1992;304:1285.
  • 12. Fathy A, Abo-Haded H, Al-Ahmadi N, El-Sonbaty M. Cardiac functions assessment in children with celiac disease and its correlation with the degree of mucosal injury: Doppler tissue imaging study. Saudi J Gastroenterol. 2016;22:441-7.
  • 13. Gupta P, Patel C, Patel H, Narayanaswamy S, Malhotra B, Green JT, et al. Tp-e/QT ratio as an index of arrhythmogenesis. Journal of Electrocardiology. 2008;41:567-74.
  • 14. Demirtaş K, Yayla Ç, Yüksel M, B Açar, S Ünal, A G Ertem, et al. Tp-e interval and Tp-e/QT ratio in patients with celiac disease. Revista Clínica Española. 2017;217:439-45.
  • 15. Demircan T, Çağan Appak Y, Baran M, Aksoy B, Güven B, Narin N, et al. Does Celiac Disease Effect Electrocardiographic Markers of Arrhythmic Events in Children? JPR. 2021;8:7-13.
  • 16. Birinci H, Yolcu C, Dogan G, Basaran MK, Elevli M. Are Tp-e interval and QT dispersion values important in children with coeliac disease? Cardiol Young. 2022;24:1-6.
  • 17. Aydin Şahi̇n D, Şahi̇n Y. Evaluation of Cardiac Functions and Electrocardiogram Parameters in Children with Celiac Disease. Osmangazi Journal of Medıcıne. Erişim adresi: https://dergipark.org.tr/en/doi/10.20515/otd.924868
  • 18. Huang J. Assessment of the causal association between celiac disease and cardiovascular diseases. Front Cardiovasc Med. 2022;9:1017209.
There are 18 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section ORİJİNAL MAKALE
Authors

Didem Gülcü Taşkın 0000-0002-2746-3799

Ali Orgun 0000-0003-1604-270X

Publication Date May 23, 2023
Published in Issue Year 2023 Volume: 45 Issue: 3

Cite

Vancouver Gülcü Taşkın D, Orgun A. The Importance of Electrocardiographic Evaluation in Patients with Celiac Disease. Osmangazi Tıp Dergisi. 2023;45(3):425-30.


13299        13308       13306       13305    13307  1330126978