Document Detail

Relationship between gastroesophageal reflux disease and myocardial ischemia. Effect of reflux on temporary activity of autonomic nervous system.
MedLine Citation:
PMID:  15631321     Owner:  NLM     Status:  MEDLINE    
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.
S Dobrzycki; D Skrodzka; W J Musiał; M Go; J Korecki; K Gugała; P Kralisz; P Prokopczuk; H Bachórzewska-Gajewska; K Kamiński
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Roczniki Akademii Medycznej w Białymstoku (1995)     Volume:  49     ISSN:  -     ISO Abbreviation:  Rocz. Akad. Med. Bialymst.     Publication Date:  2004  
Date Detail:
Created Date:  2005-01-05     Completed Date:  2005-03-29     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9515551     Medline TA:  Rocz Akad Med Bialymst     Country:  Poland    
Other Details:
Languages:  eng     Pagination:  93-7     Citation Subset:  IM    
Invasive Cardiology Department, Medical University of Białystok, Poland.
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MeSH Terms
Autonomic Nervous System / physiopathology*
Electrocardiography, Ambulatory
Gastric Acidity Determination
Gastroesophageal Reflux / complications*,  metabolism,  physiopathology
Heart Conduction System / physiopathology*
Heart Rate
Hydrogen-Ion Concentration
Middle Aged
Myocardial Ischemia / complications*,  metabolism,  physiopathology*

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