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Relationship between gastroesophageal reflux disease and myocardial ischemia. Effect of reflux on temporary activity of autonomic nervous system.
Rocz Akad Med Bialymst. 2004; 49:93-7.RA

Abstract

PURPOSE

Assessment of the gastroesophageal reflux disease (GERD) influence on myocardial ischemia and autonomic nervous system (ANS) activity.

MATERIAL AND METHODS

In 50 patients with angiographically confirmed ischemic heart disease (IHD) in I-III CCS class, simultaneous 24-hour ECG and esophageal pH-metry monitoring was performed. We assessed: (1) GERD occurrence in patients with IHD, (2) influence of pathological reflux (PR) on myocardial ischemia--number and total duration of ST depression episodes in GERD and non-GERD patients, (3) temporary activity of ANS was determined according to the dynamics of spectral HRV (Heart Rate Variability) analysis components (LF, HF, VLF, LF/HF).

RESULTS

23 patients (46%) fullfilled the GERD criteria. Patients with GERD had significantly higher number of ST depression episodes (4.13 vs 2.85, p = 0.013) as well as longer total duration of ischemia (64.73 vs 35.2 min, p = 0.034). Spectral HRV analysis showed the significant decrease of LF/HF ratio (p < 0.035), which indicates the sympathovagal balance shift towards the parasympathetic system caused by PR.

CONCLUSIONS

1. GERD is frequent condition in patients with angiographically confirmed IHD. Coexistence of GERD may predispose to the myocardial ischemia. 2. Gastroesophageal reflux may cause the shift of sympathovagal balance towards its parasympathetic component. This mechanism may induce esophago-cardiac reflex, leading to diminished myocardial perfusion.

Authors+Show Affiliations

Invasive Cardiology Department, Medical University of Białystok, Poland.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

15631321

Citation

Dobrzycki, S, et al. "Relationship Between Gastroesophageal Reflux Disease and Myocardial Ischemia. Effect of Reflux On Temporary Activity of Autonomic Nervous System." Roczniki Akademii Medycznej W Bialymstoku (1995), vol. 49, 2004, pp. 93-7.
Dobrzycki S, Skrodzka D, Musiał WJ, et al. Relationship between gastroesophageal reflux disease and myocardial ischemia. Effect of reflux on temporary activity of autonomic nervous system. Rocz Akad Med Bialymst. 2004;49:93-7.
Dobrzycki, S., Skrodzka, D., Musiał, W. J., Go, M., Korecki, J., Gugała, K., Kralisz, P., Prokopczuk, P., Bachórzewska-Gajewska, H., & Kamiński, K. (2004). Relationship between gastroesophageal reflux disease and myocardial ischemia. Effect of reflux on temporary activity of autonomic nervous system. Roczniki Akademii Medycznej W Bialymstoku (1995), 49, 93-7.
Dobrzycki S, et al. Relationship Between Gastroesophageal Reflux Disease and Myocardial Ischemia. Effect of Reflux On Temporary Activity of Autonomic Nervous System. Rocz Akad Med Bialymst. 2004;49:93-7. PubMed PMID: 15631321.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Relationship between gastroesophageal reflux disease and myocardial ischemia. Effect of reflux on temporary activity of autonomic nervous system. AU - Dobrzycki,S, AU - Skrodzka,D, AU - Musiał,W J, AU - Go,M, AU - Korecki,J, AU - Gugała,K, AU - Kralisz,P, AU - Prokopczuk,P, AU - Bachórzewska-Gajewska,H, AU - Kamiński,K, PY - 2005/1/6/pubmed PY - 2005/3/30/medline PY - 2005/1/6/entrez SP - 93 EP - 7 JF - Roczniki Akademii Medycznej w Bialymstoku (1995) JO - Rocz. Akad. Med. Bialymst. VL - 49 N2 - PURPOSE: Assessment of the gastroesophageal reflux disease (GERD) influence on myocardial ischemia and autonomic nervous system (ANS) activity. MATERIAL AND METHODS: In 50 patients with angiographically confirmed ischemic heart disease (IHD) in I-III CCS class, simultaneous 24-hour ECG and esophageal pH-metry monitoring was performed. We assessed: (1) GERD occurrence in patients with IHD, (2) influence of pathological reflux (PR) on myocardial ischemia--number and total duration of ST depression episodes in GERD and non-GERD patients, (3) temporary activity of ANS was determined according to the dynamics of spectral HRV (Heart Rate Variability) analysis components (LF, HF, VLF, LF/HF). RESULTS: 23 patients (46%) fullfilled the GERD criteria. Patients with GERD had significantly higher number of ST depression episodes (4.13 vs 2.85, p = 0.013) as well as longer total duration of ischemia (64.73 vs 35.2 min, p = 0.034). Spectral HRV analysis showed the significant decrease of LF/HF ratio (p < 0.035), which indicates the sympathovagal balance shift towards the parasympathetic system caused by PR. CONCLUSIONS: 1. GERD is frequent condition in patients with angiographically confirmed IHD. Coexistence of GERD may predispose to the myocardial ischemia. 2. Gastroesophageal reflux may cause the shift of sympathovagal balance towards its parasympathetic component. This mechanism may induce esophago-cardiac reflex, leading to diminished myocardial perfusion. UR - https://www.unboundmedicine.com/medline/citation/15631321/Relationship_between_gastroesophageal_reflux_disease_and_myocardial_ischemia__Effect_of_reflux_on_temporary_activity_of_autonomic_nervous_system_ L2 - http://www.diseaseinfosearch.org/result/2996 DB - PRIME DP - Unbound Medicine ER -