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

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.

Anahtar Kelimeler

• cardiac function
• celiac disease
• echocardiography
• electrocardiography

Çölyak Hastalığı Olan Çocuklarda Kardiyak Fonksiyonların ve Elektrokardiyografik Parametrelerin Değerlendirilmesi

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.

Anahtar Kelimeler

• Çölyak hastalığı
• ekokardiyografi
• elektrokardiyografi
• kardiyak fonksiyon

Kaynakça

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