QT dispersion in irritable bowel syndrome
Keywords:Electrocardiogram, Irritable bowel syndrome, QT dispersion
Background: The pathogenesis of irritable bowel syndrome (IBS) has not been fully elucidated. The gastrointestinal tract have a well-differentiated intrinsic nervous system and also this system is connected with nervous system. The symptoms of IBS are related with autonomic nervous system (ANS). It was also possible to see cardiovascular symptoms due to this link. This link can influence QT dispersion (QTd). The aim of this case control study is to show the cardiac effects of IBS by changes in QTd.
Methods: There were 56 newly diagnosed patients with IBS and 60 control subjects were included in this study. IBS was diagnosed using the new Roma IV Criterias. Standard 12-lead electrocardiogram (ECG) were taken in both two groups. QTd and corrected QTd (QTcd), QT max, QT min, QT avarage, Corrected QT (QTc) min, QTc max, QTc avarage values were calculated with Bazzet Formula from rest ECGs.
Results: There were 56 newly diagnosed patients with IBS and 60 control subjects were included in the study (p:0.94). The mean age of the patients and control patients were 51.75±10.41 years and 48.41±9.72 (p: 0.53) years, respectively. QTd and corrected QTd (QTcd), QT max, QT min, QT mean, Corrected QT (QTc) min, QTc max, QTc mean values were calculated. QTd and QTcd values were found to be significantly higher in the patients with IBS (40.2±7.18; 34.1±6.18 / 52±9.8; 50.6±7.61 Msec, respectively). It is concluded that, QTd (p: 0.022) and QTcd (p: 0.032) were significantly incresased in the IBS.
Conclusions: Activation of ANS in the patients with IBS can affect QT period in ECG.
Scalera A, Loguercio C. Focus on irritable bowel syndrome. Euro Rev Med Pharmacol Sci. 2012;16:1155-71.
Pope CE II. Irritable Bowel Syndrome, In: Sleisenger MH, Fordtran JS, Eds. Gastrointestinal and Liver Diseasese, pathophysiology, diagnosis, management. Volume 2. Irritable Bowel Syndrome, 9rd ed. Philadelphia. Saunders; 2010:2091-104.
Furness, John Barton. The Enteric Nervous System. John Wiley and Sons; 2008:35-38.
Beyazit Y, Sain-Güven G, İskit AB. Uzun QT sendromu. Hacettepe Tıp Dergisi. 2005;36(1):43-8.
Day CP, McComb JM, Campbell RW. QT dispersion: an indication of arrhythmia risk in patients with long QT intervals. Br Heart J. 1990;63:342-4.
Bednar MM, Harrigan EP, Anziano RJ, Camm AJ, Ruskin JN. The QT interval. Prog Cardiovasc Dis. 2001;43:11-45.
Hohnloser SH. Effect of coronary ischemia on QT dispersion: J Electrocardiol. 1999;32:199-206.
Nakagawa M, TakahashiN, Iwao T, Yonemochi H, Ooie T, Hara M, et al. Evalution of autonomic influences on QT dispersion using the head uptilt test in healty subjects. Pacing Clin Electrophysiol. 1999;22:115863.
Fujimoto S, Uemura S, Tomoda Y, Yamomoto H, Matsukura Y, Horii M, et al. Effects of exercise training on the heart rate variability and QT dispersion of patients with acute myocardial infarction. Jpn Circ J. 1999;34:242.
Rome IV diagnostic criteria for functional GI disorder SRE leased at DDW, 2016. Available at: http: http://www.romecriteria.org/assets //bit.ly/28QsQMu. Accessed on 8 November 2017.
Rautaharju PM, Surawicz B, Gettes LS. AHA/ACCF/HRS recommendations for the standardization and interpretation of the electrocardiogram: part IV: the ST segment, T and U waves, andthe QT interval: a scientific statement from the American Heart Association Electrocardiography and Arrhythmias Committee, Council on Clinical Cardiology; the American College of Cardiology Foundation and the Heart Rhythm Society. Endorsed by the International Society for Computerized Electrocardiology. J Am Coll Cardio. 2009;53:982-91.
Malik M, Batchvarov VN. Measurement, interpretation and clinical potential of QT dispersion. J Am Coll Cardiol. 2000;36:1749.
Piccirillo G, Viola E, Nocco M, Santagada E, Durante M, Bucca C, Marigliano V. Autonomic modulation and QT interval dispersion in hypertensive subjects with anxiety. Hypertension. 1999 Aug;34(2):242-6.
Stam R, Akkermans LM, Wiegant VM. Trauma and the gut: interactions between stressful experience and intestinal function. Gut. 1997 Jun;40(6):704.
Yang TY, Chen CS, Lin CL, Lin WM, Kuo CN, Kao CH. Risk for irritable bowel syndrome in fibromyalgia patients: a National Database Study. Medicine. 2017 Apr;96(14).
Triadafilopoulos G, Simms RW, Goldenberg DL. Bowel dysfunction in fibromyalgia syndrome. Dig Dis Sci. 1991;36:59-64.
Sivri A, Cindaş A, Dincer F, Sivri B. Bowel dysfunction and irritable bowel syndrome in fibromyalgia patients. Clinical Rheumatol. 1996 May 1;15(3):283-6.
Moshiree B, Price DD, Robinson ME, Gaible R, Verne GN. Thermal and visceral hypersensitivity in irritable bowel syndrome patients with and without fibromyalgia. Clin J pain. 2007 May 1;23(4):323-30.
Feng B, La JH, Schwartz ES, Gebhart GF. Irritable bowel syndrome: methods, mechanisms, and pathophysiology. Neural and neuro-immune mechanisms of visceral hypersensitivity in irritable bowel syndrome. Am J Physiol Gastrointest Liver Physiol. 2012;302:G1085-98.
Yorulmaz E, Sezgin A, Yorulmaz H, Adali G, Ciftci H. Prolong Qt dispertion in İnfammatory bowel dissease. World J Gastroenterol. 2013;19(1):65-71.
Pattanshetty DJ, Gajulapalli RD, Anna K, Biyyani RS. Prevalence of QT interval prolongation in inflammatory bowel disease. The Turkish J Gastroenterol. 2016 Mar 1;27(2):136-42.
Akkuş MN, Yazar A, Döven Ö, Akbay E. Irritable Barsak syndrome and QT dispersion. Mersin Medical J. 2000;1:26-30.