Prolonged P-Wave and QT Dispersion in Children with Inflammatory Bowel Disease in Remission.

Helen Aghdasi Bornaun,Fatih Şap,Kazım Öztarhan,Aras Tulunoğlu,Günsel Kutluk,Gonca Keskindemirci,Nuh Yılmaz,Reyhan Dedeoğlu

doi:10.1155/2017/6960810

Abstract

Objectives. Ulcerative colitis (UC) and Crohn's disease (CD) are chronic inflammatory bowel diseases (IBD) with unclear underlying aetiologies. Severe cardiac arrhythmias have been emphasised in a few studies on adult IBD patients. This study aimed to investigate the alteration of the P-wave and QT interval dispersion parameters to assess the risk of atrial conduction and ventricular repolarisation abnormalities in pediatric IBD patients. Patients and Methods. Thirty-six IBD patients in remission (UC: 20, CD: 16) aged 3–18 years and 36 age- and sex-matched control patients were enrolled in the study. Twelve-lead electrocardiograms were used to determine durations of P-wave, QT, and corrected QT (QTc) interval dispersion. Transthoracic echocardiograms and 24-hour rhythm Holter recordings were obtained for both groups. Results. The P-wave dispersion, QT dispersion, and QTc interval dispersion (Pdisp, QTdisp, and QTcdisp) were significantly longer in the patient group. The mean values of Pminimum, Pmaximum, and QTcminimum were significantly different between the two groups. The echocardiography and Holter monitoring results were not significantly different between the groups. Furthermore, no differences in these parameters were detected between the CD and UC groups. Conclusion. Results suggest that paediatric IBD patients may carry potential risks for serious atrial and ventricular arrhythmias over time even during remission.

Highlights

Inflammatory bowel disease (IBD), which has two principle types of ulcerative colitis (UC) and Crohn’s disease (CD), is composed of gastrointestinal inflammatory conditions [1, 2]
Thirty-six children who were diagnosed with IBD (20 with UC and 16 with CD) were prospectively enrolled in this study, when they were in remission phase
Disease activity of the subjects was evaluated according to the Pediatric Ulcerative Colitis Activity Index (PUCAI) [15] or Pediatric Crohn’s Disease Activity Index (PCDAI) [16] scores, and C-reactive protein level (CRP), erythrocyte sedimentation rate (ESR), white blood cells (WBC) count, and platelet (PLT) count were investigated

Summary

Introduction

Inflammatory bowel disease (IBD), which has two principle types of ulcerative colitis (UC) and Crohn’s disease (CD), is composed of gastrointestinal inflammatory conditions [1, 2]. Multiple extraintestinal manifestations are observed in approximately 23%–42% of IBD patients [1, 2]. Cardiac involvement represents one of the leading causes of morbidity and mortality [1,2,3]. There are evidences which suggested that IBD patients are at higher risk of cardiovascular disease (CVD) [3]. Cardiac involvement has been reported extensively in IBD patients such as recurrent perimyocarditis, valvular damage, venous thrombosis, and variety of cardiac arrhythmias [1, 2]

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Discussion

Conclusion