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The evaluation of gastro-oesophageal reflux and oesophagocardiac reflex in patients with angina-like chest pain following cardiologic investigations.
Int J Cardiol 2007; 118(1):62-8IJ

Abstract

The aims of the study were to assess pathogenetic role of gastro-oesophageal reflux and the oesophago-cardiac reflex in subjects with chest pain. To evaluate the prevalence of gastro-oesophageal reflux disease and the oesophago-cardiac reflex in patients with different coronary artery diseases and in coronary spasm.

PATIENTS, METHODS

Fifty-one patients with chest pain were enrolled after detailed cardiologic evaluation including coronary angiography. The prevalence of gastrooesophageal reflux disease was established by symptom analysis, upper gastrointestinal endoscopy, 24-h oesophageal pH monitoring, and oesophageal manometry. The oesophago-cardiac reflex was established by oesophageal acid perfusion test (0.1 N HCl and 0.9% NaCl, 120-120 ml/10 min in a blinded manner) combined with transoesophageal Doppler echocardiographic coronary flow measurement in the left anterior descending artery.

RESULTS

Gastro-oesophageal reflux disease was established in 45% (23/51) of the patients. Oesophageal acid perfusion decreased the coronary flow velocity in 49% (25/51) of the patients indicating the presence of oesophago-cardiac reflex. Oesophago-cardiac reflex was present more frequently in patients with coronary spasm, than in patients with either epicardial coronary artery disease or microvascular coronary disease (p<0.02). Patients with oesophago-cardiac reflex had higher DeMeester scores, increased number of reflux episodes, fraction time below pH 4, and prolonged acid reflux episodes (p<0.05 for each parameter).

CONCLUSIONS

Gastro-oesophageal reflux disease is frequently established in patients with either epicardial or microvascular coronary artery disease or with coronary spasm. The oesophago-cardiac reflex was more frequently observed in patients with coronary spasm. The combination of oesophageal acid perfusion test and transoesophageal Doppler echocardiographic coronary flow measurement seems to be a useful method for the detection of this reflex. Patients with prolonged gastro-oesophageal acid reflux episodes, erosive oesophagitis and coronary spasm may be at higher risk for the development of linked-angina.

Authors+Show Affiliations

First Department of Medicine, Albert Szent-Györgyi Medical, Centre, University of Szeged, Hungary. air@in1st.szote.u-szeged.huNo 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

Language

eng

PubMed ID

16891012

Citation

Rosztóczy, András, et al. "The Evaluation of Gastro-oesophageal Reflux and Oesophagocardiac Reflex in Patients With Angina-like Chest Pain Following Cardiologic Investigations." International Journal of Cardiology, vol. 118, no. 1, 2007, pp. 62-8.
Rosztóczy A, Vass A, Izbéki F, et al. The evaluation of gastro-oesophageal reflux and oesophagocardiac reflex in patients with angina-like chest pain following cardiologic investigations. Int J Cardiol. 2007;118(1):62-8.
Rosztóczy, A., Vass, A., Izbéki, F., Nemes, A., Rudas, L., Csanády, M., ... Wittmann, T. (2007). The evaluation of gastro-oesophageal reflux and oesophagocardiac reflex in patients with angina-like chest pain following cardiologic investigations. International Journal of Cardiology, 118(1), pp. 62-8.
Rosztóczy A, et al. The Evaluation of Gastro-oesophageal Reflux and Oesophagocardiac Reflex in Patients With Angina-like Chest Pain Following Cardiologic Investigations. Int J Cardiol. 2007 May 16;118(1):62-8. PubMed PMID: 16891012.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The evaluation of gastro-oesophageal reflux and oesophagocardiac reflex in patients with angina-like chest pain following cardiologic investigations. AU - Rosztóczy,András, AU - Vass,Andrea, AU - Izbéki,Ferenc, AU - Nemes,Attila, AU - Rudas,László, AU - Csanády,Miklós, AU - Lonovics,János, AU - Forster,Tamás, AU - Wittmann,Tibor, Y1 - 2006/08/07/ PY - 2006/02/15/received PY - 2006/05/27/accepted PY - 2006/8/8/pubmed PY - 2007/5/5/medline PY - 2006/8/8/entrez SP - 62 EP - 8 JF - International journal of cardiology JO - Int. J. Cardiol. VL - 118 IS - 1 N2 - UNLABELLED: The aims of the study were to assess pathogenetic role of gastro-oesophageal reflux and the oesophago-cardiac reflex in subjects with chest pain. To evaluate the prevalence of gastro-oesophageal reflux disease and the oesophago-cardiac reflex in patients with different coronary artery diseases and in coronary spasm. PATIENTS, METHODS: Fifty-one patients with chest pain were enrolled after detailed cardiologic evaluation including coronary angiography. The prevalence of gastrooesophageal reflux disease was established by symptom analysis, upper gastrointestinal endoscopy, 24-h oesophageal pH monitoring, and oesophageal manometry. The oesophago-cardiac reflex was established by oesophageal acid perfusion test (0.1 N HCl and 0.9% NaCl, 120-120 ml/10 min in a blinded manner) combined with transoesophageal Doppler echocardiographic coronary flow measurement in the left anterior descending artery. RESULTS: Gastro-oesophageal reflux disease was established in 45% (23/51) of the patients. Oesophageal acid perfusion decreased the coronary flow velocity in 49% (25/51) of the patients indicating the presence of oesophago-cardiac reflex. Oesophago-cardiac reflex was present more frequently in patients with coronary spasm, than in patients with either epicardial coronary artery disease or microvascular coronary disease (p<0.02). Patients with oesophago-cardiac reflex had higher DeMeester scores, increased number of reflux episodes, fraction time below pH 4, and prolonged acid reflux episodes (p<0.05 for each parameter). CONCLUSIONS: Gastro-oesophageal reflux disease is frequently established in patients with either epicardial or microvascular coronary artery disease or with coronary spasm. The oesophago-cardiac reflex was more frequently observed in patients with coronary spasm. The combination of oesophageal acid perfusion test and transoesophageal Doppler echocardiographic coronary flow measurement seems to be a useful method for the detection of this reflex. Patients with prolonged gastro-oesophageal acid reflux episodes, erosive oesophagitis and coronary spasm may be at higher risk for the development of linked-angina. SN - 1874-1754 UR - https://www.unboundmedicine.com/medline/citation/16891012/The_evaluation_of_gastro_oesophageal_reflux_and_oesophagocardiac_reflex_in_patients_with_angina_like_chest_pain_following_cardiologic_investigations_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0167-5273(06)00620-6 DB - PRIME DP - Unbound Medicine ER -