Does gastro-esophageal reflux provoke the myocardial ischemia in patients with CAD?

• Published in: International journal of cardiology 2005-09, Vol.104 (1), p.67-72
• Main Authors: Dobrzycki, Slawomir, Baniukiewicz, Andrzej, Korecki, Janusz, Bachórzewska-Gajewska, Hanna, Prokopczuk, Przemyslaw, Musial, Włodzimierz J., Kamiński, Karol A., Dąbrowski, Andrzej
• Format: Article
• Language: English
• Subjects: 24-h ECG monitoring; 24-h esophageal pH; Adult; Aged; Anti-Ulcer Agents - therapeutic use; Biological and medical sciences; Cardiology. Vascular system; Circadian Rhythm - drug effects; Coronary artery disease (CAD); Coronary Artery Disease - complications; Coronary Artery Disease - physiopathology; Coronary heart disease; Electrocardiography, Ambulatory; Esophagus; Female; Gastro-esophageal reflux disease (GERD); Gastroenterology. Liver. Pancreas. Abdomen; Gastroesophageal Reflux - complications; Gastroesophageal Reflux - drug therapy; Gastroesophageal Reflux - physiopathology; Heart; Humans; Hydrogen-Ion Concentration - drug effects; Male; Medical sciences; Middle Aged; Myocardial Contraction; Myocardial Ischemia - etiology; Myocardial Ischemia - physiopathology; Myocarditis. Cardiomyopathies; Omeprazole - therapeutic use; Other diseases. Semiology; Time Factors; Treatment Outcome
• ISSN: 0167-5273; 1874-1754
• DOI: 10.1016/j.ijcard.2004.10.018

Gastro-esophageal reflux disease (GERD) may cause chest pain. The aim was to determine the correlation between ischemia and gastro-esophageal reflux in patients with CAD and to assess the influence of short-term “anti-reflux” therapy on the ischemia in patients with GERD and CAD. Fifty patients with angiographically proven CAD underwent simultaneous 24-h continuous ECG and esophageal pH monitoring. We assessed the number of ST-segment depression episodes (ST dep.) and total duration of ischemic episodes, expressed as total ischemic burden (TIB). In pH-metry, we assessed: time percentage of pH lower than 4, total time of pH lower than 4 and the number of pathological refluxes (PR). Patients fulfilling the GERD criteria received a 7-day therapy with omeprazol 20 mg bid. On the 7th day of therapy, simultaneous Holter and esophageal pH monitoring was repeated. Total number of 224 PRs in 42 patients (84%) was recorded during esophageal pH-metry. GERD criteria were fulfilled in 23 patients (46%). Out of 218 episodes of ST dep., 45 (20.6%) correlated with PR. GERD patients had larger TIB and higher number of ST dep. ( p