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

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.

Association between Corrected QT Interval and C-Reactive Protein in Patients with Inflammatory Bowel Diseases

“…Figure 4 shows the PRISMA diagram summarizing the sequence of the literature selection. Seven studies reported on QTc interval [ 27 , 28 , 29 , 30 , 31 , 32 , 33 ]. Table 3 summarizes the results of the studies that measured the QTc interval in patients with IBD.…”

“…Population-based studies demonstrate that disease activity in IBD is associated with an increased risk of morbidity and mortality due to CVD [ 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 ]. Furthermore, a number of observations indicate that patients with IBD are at a higher risk of developing ECG abnormalities, i.e., QTc interval [ 21 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 ]. QTc interval represents the most investigated ECG parameter in patients with IBD [ 27 , 28 , 29 , 30 , 31 , 32 , 33 ].…”

“…Figure 4 shows the PRISMA diagram summarizing the sequence of the literature selection. Seven studies reported on QTc interval [27][28][29][30][31][32][33]. Table 3 There were no significant relationships between the QTc values and all the other baseline characteristics, i.e., gender, age, disease duration, type of IBD (UC or CD), and therapy.…”

“…Notably, morbidity and mortality due to CVD are exclusively observed during active IBD flares. Studies based on electrocardiogram (ECG) findings indicate that patients with IBD are at a higher risk of developing QT interval abnormalities, in particular heart-rate-corrected QT interval (QTc) [ 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 ].…”

CARDIAC ARRHYTHMIAS IN CERTAIN INTERNAL DISEASES (review)

“…По мнению ряда исследователей, системное воспаление, способствующее структурному и электрическому ремоделированию левого предсердия, является основным патофизиологическим механизмом ФП при ВЗК [19]. Известно, что дисперсия зубца P и интервала QT наблюдается уже у детей, больных ВЗК (средний стаж заболевания -16 месяцев) [18].…”