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Çölyak Hastalığı Olan Çocuklarda Kardiyak Fonksiyonların ve Elektrokardiyografik Parametrelerin Değerlendirilmesi

Yıl 2021, , 505 - 511, 13.09.2021
https://doi.org/10.20515/otd.924868

Öz

Çölyak hastalığı tanılı çocuk hastalarda atriyal ve ventriküler aritmi gelişiminde belirleyici olan elektrokardiyogram (EKG) parametrelerini ve kardiyak fonksiyonları değerlendirmeyi amaçladık. 2017 Mart-2020 Haziran dönemlerinde çölyak hastalığı tanısı ile takip edilen 28 hasta retrospektif olarak değerlendirildi. Yaş ve cinsiyet uyumlu 33 hasta kontrol grubu olarak alındı. Tüm hasta ve kontrol grubuna Ekokardiyografi (EKO) ve 12 kanallı elektrokardiyogram tetkiki yapıldı. Hastaların 16'sı kız (%57,1) olup ortalama yaşları 9,46±4,20 yıl idi. Ortalama çölyak hastalığı takip süresi 2,17±2,21 yıl idi. Çölyak hastalarında Tp-e intervali, QTc, QTc dispersiyonu, Tp-e/QT ve Tp-e/QTc oranları kontrol grubuna göre daha uzun saptandı (p <0.05). Hastalar seronegatif (glutensiz diyete uyumlu) ve seropozitif (glutensiz diyete uyumsuz) çölyak hastaları olarak 2 gruba ayrıldı. Her iki grup arasında yaş ve cinsiyet yönünden istatistiksel olarak fark yoktu. Seropozitif hastalarda yani diyete uymayan hastalarda Tp-e intervali, Tp-e/QT ve Tp-e/QTc daha uzun saptandı (p<0.05) Çölyak hastalarında Tp-e intervali, QTc, QTc dispersiyonu, Tp-e/QT oranlarını kontrol grubuna göre daha uzun saptadık. Diğer bir deyişle, sadece ventriküler aritmi göstergelerini daha uzun saptadık. Ayrıca glutensiz diyete uymayan hastalarımızda Tp-e intervali, Tp-e/QT ve Tp-e/QTc oranlarını daha uzun saptadık. Tedavi edilmemiş çölyak hastalarında ventriküler aritmi riskinin daha yüksek olduğunu tespit ettik. Daha kesin yorum yapabilmek için daha uzun takip sürelerine sahip daha fazla hasta içeren çalışmalara ihtiyaç olduğunu düşünüyoruz.

Destekleyen Kurum

Yok

Proje Numarası

Yok

Kaynakça

  • Referans 1. Husby S, Koletzko S, Korponay-Szabo IR, et al.; ESPGHAN Working Group on Coeliac Disease Diagnosis; ESPGHAN Gastroenterology Committee; European Society for Pediatric Gastroenterology, Hepatology, and Nutrition. European Society for Pediatric Gastroenterology, hepatology, and nutrition guidelines for the diagnosis of coeliac disease. J Pediatr Gastroenterol Nutr 2012; 54: 136-60.
  • Referans 2. Singh P, Arora A, Strand TA, et al. Global Prevalence of Celiac Disease: Systematic Review and Meta-analysis. Clin Gastroenterol 2018; 16: 823-36.
  • Referans 3. Bayar N, Çağırcı G, Üreyen ÇM, et al. The relationship between spontaneous multi-vessel coronary artery dissection and celiac disease. Korean Circ J 2015; 45: 242-244.
  • Referans 4. Wang I, Hopper I. Celiac disease and drug absorption: implications for cardiovascular therapeutics. Cardiovasc Ther 2014; 32: 253-256.
  • Referans 5. Curione M, Barbato M, Di Biase L, et al. Prevalence of coeliac disease in idiopathic dilated cardiomyopathy. Lancet 1999; 354: 222-3.
  • Referans 6. Frustaci A, Cuoco L, Chimenti C, et al. Celiac disease associated with autoimmune myocarditis. Circulation 2002; 105: 2611-8.
  • Referans 7. Chimenti C, Pieroni M, Maseri A, et al. Dilated cardiomyopathy and celiac disease. Ital Heart J 2002; 3: 385.
  • Referans 8. Corazza GR, Frisoni M, Filipponi C, et al. Investigation of QT interval in adult coeliac disease. BMJ 1992; 304: 1285.
  • Referans 9. Ciaccio EJ, Lewis SK, Biviano AB, et al. Cardiovascular involvement in celiac disease. World J Cardiol 2017; 9: 652-666.
  • Referans 10. West J, Logan RF, Card TR, et al. Risk of vascular disease in adults with diagnosed coeliac disease: a population based study. Aliment Pharmacol Ther 2004; 20: 73-79.
  • Referans 11. Emilsson L, Smith JG, West J, et al. Increased risk of atrial fibrillation in patients with coeliac disease: a nationwide cohort study. Eur Heart J 2011; 32: 2430-2437.
  • Referans 12. Schuppan D: Current concepts of celiac disease pathogenesis. Gastroenterology 2006; 119: 234-242.
  • Referans 13. Ventura A, Magazzu G, Greco L. Duration of exposure to gluten and risk for autoimmune disorders in patients with celiac disease. SIGEP Study Group for Autoimmune Disorders in Celiac Disease. Gastroenterology 1999; 117: 297-303.
  • Referans 14. Cosnes J, Cellier C, Viola S, et al; Groupe D'Etude et de Recherche Sur la Maladie Coeliaque. Incidence of autoimmune diseases in celiac disease: protective effect of the gluten-free diet. Clin Gastroenterol Hepatol 2008; 6: 753-758.
  • Referans 15. Polat TB, Urganci N, Yalcin Y, et al. Cardiac functions in children with coeliac disease during follow-up: insights from tissue Doppler imaging. Dig Liver Dis 2008; 40: 182-187.
  • Referans 16. Saylan B, Cevik A, Kirsaclioglu CT, et al. Subclinical Cardiac Dysfunction in Children with Coeliac Disease: Is the Gluten-Free Diet Effective? ISRN Gastroenterol 2012; 2012: 706937.
  • Referans 17. Fathy A, Abo-Haded HM, Al-Ahmadi N, et al. Cardiac Functions Assessment in Children with Celiac Disease and its Correlation with the Degree of Mucosal Injury: Doppler Tissue Imaging Study. Saudi J Gastroenterol 2016; 22: 441-447.
  • Referans 18. Bolia R, Srivastava A, Kapoor A, et al. Children with untreated coeliac disease have sub-clinical cardiac dysfunction: a longitudinal observational analysis. Scand J Gastroenterol 2018; 53: 803-808.
  • Referans 19. Demircan T, Appak YÇ, Baran M, et al. Does Celiac Disease Effect Electrocardiographic Markers of Arrhythmic Events in Children? J Pediatr Res 2021; 8: 7-13.
  • Referans 20. Deveci M, Uncuoğlu Aydoğan A, Altun G, et al. Left ventricular mechanics are affected in children with celiac disease: A study based on two-dimensional speckle tracking echocardiography. Echocardiography 2017; 34: 1339-1346.
  • Referans 21. Karadaş U, Eliaçık K, Baran M, et al. The subclinical effect of celiac disease on the heart and the effect of gluten-free diet on cardiac functions. Turk J Pediatr 2016; 58: 241-245.
  • Referans 22. Sahn DJ, DeMaria A, Kisslo J, et al. Recommendations regarding quantitation in M-mode echocardiography: results of a survey of echocardiographic measurements. Circulation 1978; 58: 1072-83.
  • Referans 23. Folland ED, Parisi AF, Moynihan PF, et al. Assessment of left ventricular ejection fraction and volumes by real-time, two-dimensional echocardiography. A comparison of cineangiographic and radionuclide techniques. Circulation 1979;60:760-6.
  • Referans 24. Garampazzi A, Rapa A, Mura S, et al. Clinical pattern of celiac disease is still changing. J Pediatr Gastroenterol Nutr 2007; 45: 611–4.
  • Referans 25. Krauthammer A, Guz-Mark A, Zevit N, et al. Two decades of pediatric celiac disease in a tertiary referral center: What has changed? Digestive and Liver Disease 2020; 52: 457-61.
  • Referans 26. Hujoel IA, Van Dyke CT, Brantner T, et al. Natural history and clinical detection of undiagnosed coeliac disease in a north American community. Aliment Pharmacol Ther 2018; 47: 1358–66.
  • Referans 27. Murch S, Jenkins H, Auth M, et al; BSPGHAN. Joint BSPGHAN and Coeliac UK guidelines for the diagnosis and management of coeliac disease in children. Arch Dis Child. 2013; 98: 806-11.
  • Referans 28. Gajulapalli RD. Prevalence of atrial fibrillation in patient with celiac disease. Circulation 2014; 130 (Suppl 2): A12318.
  • Referans 29. Sari C, Bayram NA, Dogan FE, et al. The evaluation of endothelial functions in patients with celiac disease. Echocardiography. 2012; 29: 471-7.
  • Referans 30. Van Elburg RM, Uil JJ, Mulder CJ, et al. Intestinal permeability in patients with coeliac disease and relatives of patients with coeliac disease. Gut 1993; 34: 354-7.
  • Referans 31. DeMeo MT, Mutlu EA, Keshavarzian A, et al. Intestinal permeation and gastrointestinal disease. J Clin Gastroenterol 2002; 34: 385-96.
  • Referans 32. Curione M, Barbato M, Viola F, et al. Idiopathic dilated cardiomyopathy associated with coeliac disease: the effect of a gluten-free diet on cardiac performance. Dig Liver Dis 2002; 34: 866-9.
  • Referans 33. Efe TH, Ertem AG, Coskun Y, et al. Atrial Electromechanical Properties in Coeliac Disease. Heart Lung Circ 2016; 25: 160-5.
  • Referans 34. Chung MK, Martin DO, Sprecher D, et al. C-reactive protein elevation in patients with atrial arrhythmias: inflammatory mechanisms and persistence of atrial fibrillation. Circulation 2001; 104: 2886-2891.
  • Referans 35. Frustaci A, Chimenti C, Bellocci F, et al. Histological substrate of atrial biopsies in patients with lone atrial fibrillation. Circulation 1997; 96: 1180-1184.
  • Referans 36. Bayar N, Çekin AH, Arslan Ş, et al. Assessment of Left Atrial Function in Patients with Celiac Disease. Echocardiography 2015; 32: 1802-1808.
  • Referans 37. Demirtaş K, Yayla Ç, Yüksel M, et al. Tp-e interval and Tp-e/QT ratio in patients with celiac disease. Rev Clin Esp 2017; 217: 439-445.
  • Referans 38. Karadeniz C, Özdemir R, Demirol M, et al. Low iron stores in otherwise healthy children affect electrocardiographic markers of important cardiac events. Pediatr Cardiol 2017; 38: 909-14.
  • Referans 39. Das BB, Sharma J. Repolarization abnormalities in children with a structurally normal heart and ventricular ectopy. Pediatr Cardiol 2004; 25: 354-6.
  • Referans 40. Bluzaite I, Brazdzionyte J, Zaliunas R, et al. QT dispersion and heart rate variability in sudden death risk stratification in patients with ischemic heart disease. Med Kaunas 2006; 42: 450-4.
  • Referans 41. Gupta P, Patel C, Patel H, et al. Tp-e/QT ratio as an index of arrhythmogenesis. J Electrocardiol 2008; 41:567-74.
  • Referans 42. Callejas Rubio JL, Ortego N, et al. Celiac disease presenting as chronic anemia associated with heart block. Am J Gastroenterol 1998; 93: 1391-1392.
  • Referans 43. Stöllberger C, Finsterer J. Ischemic stroke in left ventricular noncompaction and celiac disease. Int J Cardiol 2014; 176: 534-536.
  • Referans 44. Lionetti E, Parisi G, Sciacca P, et al. Cardiac involvement in children with coeliac disease and the effect of gluten free diet on cardiac performance.Dig Liver Dis 2006; 38: 87-120.
  • Referans 45. Lionetti E, Catassi C, Francavilla R, et al. Subclinic cardiac involvement in paediatric patients with celiac disease: a novel sign for a case fnding approach. J Biol Regul Homeost Agents 2012; 26: S63-8.
  • Referans 46. Nygard O, Vollset SE, Refsum H, et al. Total homocysteine and cardiovascular disease. J Intern Med 1999; 246: 425-454.
  • Referans 47. Cai BZ, Gong DM, Liu Y, et al. Homocysteine inhibits potassium channels in human atrial myocytes. Clin Exp Pharmacol Physiol 2007; 34: 851-855.
  • Referans 48. Cai B, Shan L, Gong D, et al. Homocysteine modulates sodium channel currents in human atrial myocytes. Toxicology 2009; 256: 201-206.
  • Referans 49. Hallert C, Grant C, Grehn S, et al. Evidence of poor vitamin status in coeliac patients on a gluten-free diet for 10 years . Aliment Pharmacol Ther 2002; 16: 1333-1339.
  • Referans 50. Wei L, Spiers E, Reynolds N, et al. The association between coeliac disease and cardiovascular disease. Aliment Pharmacol Ther 2008; 27: 514-9.
  • Referans 51. Goel NK, McBane RD, Kamath PS. Cardiomyopathy associated with celiac disease. Mayo Clin Proc. 2005; 80: 674-6.
  • Referans 52. Poddar B, Shava U, Srivastava A, et al. Severe heart failure, dilated cardiomyopathy and pulmonary haemosiderosis in coeliac disease: report of two cases. Paediatr Int Child Health 2014; 34: 142-144.
  • Referans 53. Cenk S, Aylin DB, Fatma Ebru A, et al. Assessment of lef ventricular function by strain-strain rate echocardiography in patients with celiac disease. Turk J Med Sci 2014; 44: 173-177.

Evaluation of Cardiac Functions and Electrocardiogram Parameters in Children with Celiac Disease

Yıl 2021, , 505 - 511, 13.09.2021
https://doi.org/10.20515/otd.924868

Öz

We aimed to evaluate cardiac functions and electrocardiogram (ECG) parameters that are determinant in the development of atrial and ventricular arrhythmia in children with celiac disease.Twenty-eight patients with celiac disease followed up between March 2017 and June 2020 were evaluated retrospectively. 33 age-and sex-matched healthy children were included as the control group. Echocardiography (ECHO) and 12-lead ECG were performed in all patients and controls. Of the 28 patients, 16 were girls (57.1%) and their mean age was 9.46±4.20 years. The mean duration time of celiac disease was 2.17±2.21 years. The Tp-e interval, QTc, QTc dispersion, and Tp-e / QT ratio were detected longer in celiac patients than in the control group (p <0.05). The patients were divided into 2 groups as seronegative (patients adhering to the gluten free-diet (GFD)) and seropositive celiac patients (patients not adhering to the GFD). There was no statistically significant difference between the two groups in terms of age and gender. The Tp-e interval, Tp-e / QT and Tp-e / QTc was determined longer in seropositive celiac patients. We found prolonged Tp-e interval, QTc, QTc dispersion and Tp-e / QT ratio in patients with celiac disease. In other words, we only detected the ventricular arrhythmia indicators as longer. In addition, we found prolonged Tp-e interval, Tp-e / QT and Tp-e / QTc in patients not adhering to a strict GFD. We detected that untreated celiac patients have a higher risk of ventricular arrhythmia. We think that further studies with more pediatric celiac patients who have longer duration of disease are needed for precise interpretation.

Proje Numarası

Yok

Kaynakça

  • Referans 1. Husby S, Koletzko S, Korponay-Szabo IR, et al.; ESPGHAN Working Group on Coeliac Disease Diagnosis; ESPGHAN Gastroenterology Committee; European Society for Pediatric Gastroenterology, Hepatology, and Nutrition. European Society for Pediatric Gastroenterology, hepatology, and nutrition guidelines for the diagnosis of coeliac disease. J Pediatr Gastroenterol Nutr 2012; 54: 136-60.
  • Referans 2. Singh P, Arora A, Strand TA, et al. Global Prevalence of Celiac Disease: Systematic Review and Meta-analysis. Clin Gastroenterol 2018; 16: 823-36.
  • Referans 3. Bayar N, Çağırcı G, Üreyen ÇM, et al. The relationship between spontaneous multi-vessel coronary artery dissection and celiac disease. Korean Circ J 2015; 45: 242-244.
  • Referans 4. Wang I, Hopper I. Celiac disease and drug absorption: implications for cardiovascular therapeutics. Cardiovasc Ther 2014; 32: 253-256.
  • Referans 5. Curione M, Barbato M, Di Biase L, et al. Prevalence of coeliac disease in idiopathic dilated cardiomyopathy. Lancet 1999; 354: 222-3.
  • Referans 6. Frustaci A, Cuoco L, Chimenti C, et al. Celiac disease associated with autoimmune myocarditis. Circulation 2002; 105: 2611-8.
  • Referans 7. Chimenti C, Pieroni M, Maseri A, et al. Dilated cardiomyopathy and celiac disease. Ital Heart J 2002; 3: 385.
  • Referans 8. Corazza GR, Frisoni M, Filipponi C, et al. Investigation of QT interval in adult coeliac disease. BMJ 1992; 304: 1285.
  • Referans 9. Ciaccio EJ, Lewis SK, Biviano AB, et al. Cardiovascular involvement in celiac disease. World J Cardiol 2017; 9: 652-666.
  • Referans 10. West J, Logan RF, Card TR, et al. Risk of vascular disease in adults with diagnosed coeliac disease: a population based study. Aliment Pharmacol Ther 2004; 20: 73-79.
  • Referans 11. Emilsson L, Smith JG, West J, et al. Increased risk of atrial fibrillation in patients with coeliac disease: a nationwide cohort study. Eur Heart J 2011; 32: 2430-2437.
  • Referans 12. Schuppan D: Current concepts of celiac disease pathogenesis. Gastroenterology 2006; 119: 234-242.
  • Referans 13. Ventura A, Magazzu G, Greco L. Duration of exposure to gluten and risk for autoimmune disorders in patients with celiac disease. SIGEP Study Group for Autoimmune Disorders in Celiac Disease. Gastroenterology 1999; 117: 297-303.
  • Referans 14. Cosnes J, Cellier C, Viola S, et al; Groupe D'Etude et de Recherche Sur la Maladie Coeliaque. Incidence of autoimmune diseases in celiac disease: protective effect of the gluten-free diet. Clin Gastroenterol Hepatol 2008; 6: 753-758.
  • Referans 15. Polat TB, Urganci N, Yalcin Y, et al. Cardiac functions in children with coeliac disease during follow-up: insights from tissue Doppler imaging. Dig Liver Dis 2008; 40: 182-187.
  • Referans 16. Saylan B, Cevik A, Kirsaclioglu CT, et al. Subclinical Cardiac Dysfunction in Children with Coeliac Disease: Is the Gluten-Free Diet Effective? ISRN Gastroenterol 2012; 2012: 706937.
  • Referans 17. Fathy A, Abo-Haded HM, Al-Ahmadi N, et al. Cardiac Functions Assessment in Children with Celiac Disease and its Correlation with the Degree of Mucosal Injury: Doppler Tissue Imaging Study. Saudi J Gastroenterol 2016; 22: 441-447.
  • Referans 18. Bolia R, Srivastava A, Kapoor A, et al. Children with untreated coeliac disease have sub-clinical cardiac dysfunction: a longitudinal observational analysis. Scand J Gastroenterol 2018; 53: 803-808.
  • Referans 19. Demircan T, Appak YÇ, Baran M, et al. Does Celiac Disease Effect Electrocardiographic Markers of Arrhythmic Events in Children? J Pediatr Res 2021; 8: 7-13.
  • Referans 20. Deveci M, Uncuoğlu Aydoğan A, Altun G, et al. Left ventricular mechanics are affected in children with celiac disease: A study based on two-dimensional speckle tracking echocardiography. Echocardiography 2017; 34: 1339-1346.
  • Referans 21. Karadaş U, Eliaçık K, Baran M, et al. The subclinical effect of celiac disease on the heart and the effect of gluten-free diet on cardiac functions. Turk J Pediatr 2016; 58: 241-245.
  • Referans 22. Sahn DJ, DeMaria A, Kisslo J, et al. Recommendations regarding quantitation in M-mode echocardiography: results of a survey of echocardiographic measurements. Circulation 1978; 58: 1072-83.
  • Referans 23. Folland ED, Parisi AF, Moynihan PF, et al. Assessment of left ventricular ejection fraction and volumes by real-time, two-dimensional echocardiography. A comparison of cineangiographic and radionuclide techniques. Circulation 1979;60:760-6.
  • Referans 24. Garampazzi A, Rapa A, Mura S, et al. Clinical pattern of celiac disease is still changing. J Pediatr Gastroenterol Nutr 2007; 45: 611–4.
  • Referans 25. Krauthammer A, Guz-Mark A, Zevit N, et al. Two decades of pediatric celiac disease in a tertiary referral center: What has changed? Digestive and Liver Disease 2020; 52: 457-61.
  • Referans 26. Hujoel IA, Van Dyke CT, Brantner T, et al. Natural history and clinical detection of undiagnosed coeliac disease in a north American community. Aliment Pharmacol Ther 2018; 47: 1358–66.
  • Referans 27. Murch S, Jenkins H, Auth M, et al; BSPGHAN. Joint BSPGHAN and Coeliac UK guidelines for the diagnosis and management of coeliac disease in children. Arch Dis Child. 2013; 98: 806-11.
  • Referans 28. Gajulapalli RD. Prevalence of atrial fibrillation in patient with celiac disease. Circulation 2014; 130 (Suppl 2): A12318.
  • Referans 29. Sari C, Bayram NA, Dogan FE, et al. The evaluation of endothelial functions in patients with celiac disease. Echocardiography. 2012; 29: 471-7.
  • Referans 30. Van Elburg RM, Uil JJ, Mulder CJ, et al. Intestinal permeability in patients with coeliac disease and relatives of patients with coeliac disease. Gut 1993; 34: 354-7.
  • Referans 31. DeMeo MT, Mutlu EA, Keshavarzian A, et al. Intestinal permeation and gastrointestinal disease. J Clin Gastroenterol 2002; 34: 385-96.
  • Referans 32. Curione M, Barbato M, Viola F, et al. Idiopathic dilated cardiomyopathy associated with coeliac disease: the effect of a gluten-free diet on cardiac performance. Dig Liver Dis 2002; 34: 866-9.
  • Referans 33. Efe TH, Ertem AG, Coskun Y, et al. Atrial Electromechanical Properties in Coeliac Disease. Heart Lung Circ 2016; 25: 160-5.
  • Referans 34. Chung MK, Martin DO, Sprecher D, et al. C-reactive protein elevation in patients with atrial arrhythmias: inflammatory mechanisms and persistence of atrial fibrillation. Circulation 2001; 104: 2886-2891.
  • Referans 35. Frustaci A, Chimenti C, Bellocci F, et al. Histological substrate of atrial biopsies in patients with lone atrial fibrillation. Circulation 1997; 96: 1180-1184.
  • Referans 36. Bayar N, Çekin AH, Arslan Ş, et al. Assessment of Left Atrial Function in Patients with Celiac Disease. Echocardiography 2015; 32: 1802-1808.
  • Referans 37. Demirtaş K, Yayla Ç, Yüksel M, et al. Tp-e interval and Tp-e/QT ratio in patients with celiac disease. Rev Clin Esp 2017; 217: 439-445.
  • Referans 38. Karadeniz C, Özdemir R, Demirol M, et al. Low iron stores in otherwise healthy children affect electrocardiographic markers of important cardiac events. Pediatr Cardiol 2017; 38: 909-14.
  • Referans 39. Das BB, Sharma J. Repolarization abnormalities in children with a structurally normal heart and ventricular ectopy. Pediatr Cardiol 2004; 25: 354-6.
  • Referans 40. Bluzaite I, Brazdzionyte J, Zaliunas R, et al. QT dispersion and heart rate variability in sudden death risk stratification in patients with ischemic heart disease. Med Kaunas 2006; 42: 450-4.
  • Referans 41. Gupta P, Patel C, Patel H, et al. Tp-e/QT ratio as an index of arrhythmogenesis. J Electrocardiol 2008; 41:567-74.
  • Referans 42. Callejas Rubio JL, Ortego N, et al. Celiac disease presenting as chronic anemia associated with heart block. Am J Gastroenterol 1998; 93: 1391-1392.
  • Referans 43. Stöllberger C, Finsterer J. Ischemic stroke in left ventricular noncompaction and celiac disease. Int J Cardiol 2014; 176: 534-536.
  • Referans 44. Lionetti E, Parisi G, Sciacca P, et al. Cardiac involvement in children with coeliac disease and the effect of gluten free diet on cardiac performance.Dig Liver Dis 2006; 38: 87-120.
  • Referans 45. Lionetti E, Catassi C, Francavilla R, et al. Subclinic cardiac involvement in paediatric patients with celiac disease: a novel sign for a case fnding approach. J Biol Regul Homeost Agents 2012; 26: S63-8.
  • Referans 46. Nygard O, Vollset SE, Refsum H, et al. Total homocysteine and cardiovascular disease. J Intern Med 1999; 246: 425-454.
  • Referans 47. Cai BZ, Gong DM, Liu Y, et al. Homocysteine inhibits potassium channels in human atrial myocytes. Clin Exp Pharmacol Physiol 2007; 34: 851-855.
  • Referans 48. Cai B, Shan L, Gong D, et al. Homocysteine modulates sodium channel currents in human atrial myocytes. Toxicology 2009; 256: 201-206.
  • Referans 49. Hallert C, Grant C, Grehn S, et al. Evidence of poor vitamin status in coeliac patients on a gluten-free diet for 10 years . Aliment Pharmacol Ther 2002; 16: 1333-1339.
  • Referans 50. Wei L, Spiers E, Reynolds N, et al. The association between coeliac disease and cardiovascular disease. Aliment Pharmacol Ther 2008; 27: 514-9.
  • Referans 51. Goel NK, McBane RD, Kamath PS. Cardiomyopathy associated with celiac disease. Mayo Clin Proc. 2005; 80: 674-6.
  • Referans 52. Poddar B, Shava U, Srivastava A, et al. Severe heart failure, dilated cardiomyopathy and pulmonary haemosiderosis in coeliac disease: report of two cases. Paediatr Int Child Health 2014; 34: 142-144.
  • Referans 53. Cenk S, Aylin DB, Fatma Ebru A, et al. Assessment of lef ventricular function by strain-strain rate echocardiography in patients with celiac disease. Turk J Med Sci 2014; 44: 173-177.
Toplam 53 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Kurumları Yönetimi
Bölüm ORİJİNAL MAKALELER / ORIGINAL ARTICLES
Yazarlar

Derya Aydın Şahin 0000-0002-8520-2335

Yasin Şahin 0000-0002-7394-4884

Proje Numarası Yok
Yayımlanma Tarihi 13 Eylül 2021
Yayımlandığı Sayı Yıl 2021

Kaynak Göster

Vancouver Aydın Şahin D, Şahin Y. Evaluation of Cardiac Functions and Electrocardiogram Parameters in Children with Celiac Disease. Osmangazi Tıp Dergisi. 2021;43(5):505-11.


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