Abstract
Background and objectives: Electrocardiograph abnormalities (i.e., QT interval prolongation) have been described in inflammatory bowel diseases (IBD). We aimed to measure the QT interval in a cohort of patients with IBD and to analyze its relationship with clinical and inflammatory activity. Materials and Methods: We performed a cross-sectional study that included 38 IBD outpatients and 38 “age- and sex-matched” healthy controls. Nine patients had active IBD, and 29 were in clinical remission. Among the latter, 10 patients had sustained (lasting >1 year) and 19 had short-term remission (≤1 year). Corrected QT (QTc) interval was measured on standard 12-lead electrocardiograph. A systematic review of the literature on studies investigating the QT interval in patients with IBD was also performed. Results: QTc interval values were similar between IBD patients and healthy controls (417.58 ± 22.05 ms vs. 409.13 ± 19.61 ms, respectively; p: 0.479). Patients with active IBD had significantly higher QTc values (435.11 ± 27.31 ms) than both controls (409.13 ± 19.61 ms) and patients in remission (412.14 ± 17.33 ms) (p: 0.031). Post hoc analysis showed that the difference in QTc values between active IBD and remission was attributable to the group of patients with sustained remission (p < 0.05). Lastly, a significant correlation between QTc interval and C-reactive protein (CRP) values was observed (Spearman test: r = 0.563; p: 0.0005). Conclusions: Our study demonstrates an association between QTc duration and both clinical and inflammatory activity in patients with IBD. The higher the CRP value, the longer is the QTc duration. For practical purposes, all patients with active IBD should undergo a standard ECG. Prescription of drugs able to modify the QT interval should be avoided in patients with active IBD. The systematic review of the literature indicated that this is the first published study demonstrating an association between the QTc duration and CRP values in patients with IBD.
Highlights
Inflammatory bowel diseases (IBDs), i.e., ulcerative colitis (UC) and Crohn’s disease (CD), are characterized by an idiopathic inflammatory process of the intestine and a chronic relapsing course [1,2]
The results of our study demonstrate that both clinical and inflammatory activity are significantly associated with QTc duration in patients with IBD
The need to evaluate cardiac function in patients with IBD became apparent in the last few years, following ever-increasing evidence that systemic inflammation may affect heart function [12,13,14,15]
Summary
Inflammatory bowel diseases (IBDs), i.e., ulcerative colitis (UC) and Crohn’s disease (CD), are characterized by an idiopathic inflammatory process of the intestine and a chronic relapsing course [1,2]. Intestinal inflammation is responsible for signs, symptoms, and complications of IBD, being capable to trigger inflammatory responses even beyond the bowel. The more the intestinal inflammation is active, the higher is the inflammatory overflow into circulation [1,2,3,4]. Systemic inflammation is responsible for many effects, of which the most known is the acute phase response [5]. Electrocardiograph abnormalities (i.e., QT interval prolongation) have been described in inflammatory bowel diseases (IBD). We aimed to measure the QT interval in a cohort of patients with IBD and to analyze its relationship with clinical and inflammatory activity. Nine patients had active IBD, and 29 were in clinical remission. Corrected QT (QTc) interval was measured on standard 12-lead electrocardiograph
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