Abstract

OBJECTIVES
To estimate the prevalence of gastroesophageal reflux (GER) and its clinical relevance with other manifestations in Chinese patients with systemic sclerosis (SSc).
METHODS
A prospective cross-sectional study of 205 Chinese patients with SSc was conducted at Peking Union Medical College Hospital (PUMCH). GER was diagnosed as mild heartburn or regurgitation ≥2 days per week, or moderate/severe heartburn or regurgitation ≥1 day a week. PAH was defined as pulmonary artery systolic pressure (PASP) >45mmHg at rest as estimated by transthoracic echocardiography (TTE). Demographic, clinical, and laboratory data were calculated between GER and non-GER groups, and relative examinations including a six-minute walk test, pulmonary function test and modified Rodnan skin score (mRSS) were also performed.
RESULTS
The prevalence of GER was 43.90% (90/205) among 205 Chinese patients with SSc. The presence of Raynaud phenomenon (98.9% vs. 92.2%), fingertip ulcers (56.7% vs. 51.3%), pulmonary arterial hypertension (PAH) (18.89% vs. 6.96%, respectively), and all gastrointestinal tract manifestations occurred significantly more frequent in patients with GER than in patients without GER, respectively (p<0.05). There were no differences in the development of any autoantibody between GER patients and non-GER patients (p>0.05). Echocardiography showed that the left ventricular ejection fraction (LVEF) was lower (62.27±10.48 vs. 70.09±5.26, respectively) and pericarditis was more frequent (22.6% vs. 11.0%, respectively) in SSc-related GER than in SSc patients without GER, respectively. The New York Heart Association (NYHA) functional class of SSc-related GER was worse than patients without GER (p=0.015). A pulmonary function test showed that forced vital capacity FVC% (78.93±17.90 vs. 84.55±17.45, respectively, p=0.042), forced expiratory volume FEV1% (77.12±15.65 vs. 84.30±16.25, respectively, p=0.004), and diffusing capacity DLCO% (4.76±1.76 vs. 5.63±2.12, respectively, p<0.001) were lower, and the FVC%/DLCO% ratio (1.46±0.42 vs. 1.28±0.27, respectively, p=0.001)was higher in SSc-related GER than non-GER patients (p<0.05). We also found that GER was an independent risk factor of PAH in SSc patients (p=0.030, OR=7.532).
CONCLUSIONS
GER is common in Chinese patients with SSc, and patients with GER are susceptible to microvascular damage. Therefore, SSc patients presenting with GER should be screened for PAH.

Links

Publisher Full Text

Authors

Liu X, Li M, Xu D, Hou Y, Wang Q, Tian Z, Sun Q, Zeng X

Institution

Department of Rheumatology, Chinese Academy of Medical Science, Beijing, China. lxjw2009@gmail.com

Source

Clinical and experimental rheumatology 30:2 Suppl 71 pg S60-6

MeSH

Adolescent
Adult
Aged
Asian Continental Ancestry Group
Chi-Square Distribution
Child
China
Cross-Sectional Studies
Female
Gastroesophageal Reflux
Humans
Hypertension, Pulmonary
Logistic Models
Male
Middle Aged
Odds Ratio
Predictive Value of Tests
Prevalence
Prognosis
Prospective Studies
Risk Assessment
Risk Factors
Scleroderma, Systemic
Severity of Illness Index
Young Adult

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22691211