Кардиоваскулярная терапия и профилактика (Aug 2006)
Helicobacter pylori infection, esophagitis severity, and myocardial electrical instability in patients with coronary heart disease and gastroesophageal reflux disease
Abstract
Aim. To investigate correlations of gastro-esophageal reflux (GER), Helicobacter pylori (HP) infection, and myocardial electric instability markers in patients with coronary heart disease (CHD) and GER disease (GERD). Material and methods. In total, 225 patients were examined: 67 individuals with CHD and GERD (main group), and two comparison groups: 72 CHD patients, and 86 GERD subjects. Markers of myocardial electric instability included: duration and asynchrony of repolarization. To assess GER influence on heart function, Bernstein test was used, combined with 24-hour electrocardiogram (ECG) monitoring. GERD was diagnosed by endoscopy data. GERD with catarrhal or erosive reflux-esophagitis (CRE, ERE) were registered. HP infection was diagnosed by polymerase chain reaction (PCR) and histobacterioscopy of gastric mucosa bioptates. Results. In CHD and GERD patients, ST segment ischemic changes, ventricular extrasystolia (VE) were registered more often. With associated ERE, these heart function disturbances were more frequent than in CRE. In patients with combined pathology, high HP invasion of gastric mucosa was significantly associated with greater duration and asynchrony of repolarization. Myocardial repolarization duration was independently linked to CHD exacerbation, red blood cell sedimentation rate, and HP dissemination of gastric mucosa. Inhomogeneity of myocardial repolarization was linked to myocardial infarction in anamnesis and RE severity. Factors affecting heart function during Bernstein test, HP infection, increased level of C-reactive protein, and instable CHD were independent predictors of RE development in imitated GER. Conclusion. In patients with CHD and GERD, myocardial electric instability was linked to RE severity and HP status.
