The mechanistic study of inflammatory response mediated atrial fibrillation induced by gastroesophageal reflux disease

doi:10.3877/cma.j.issn.2095-8765.2022.01.005

Abstract

Abstract:

Objective

To investigate the effect of amiodarone hydrochloride combined with esmeralazole on GERD patients with atrial fibrillation(AF).

Methods

A retrospective analysis was made on 87 GERD patients with AF whom admitted to our hospital from January 2019 to November 2019. According to the different treatment methods, the patients were further divided into two groups: the control group (treated with amiodarone hydrochloride and omeprazole) and the study group (treated with amiodarone hydrochloride and omeprazole); Both groups received treatment for one month. GERD symptom score, 24 h pH monitoring and high-resolution esophageal manometry were used to analyze the effects of acid suppression, gastroesophageal motility and atrial fibrillation before and after treatment.

Results

After 24 h pH monitoring, GERD symptom score, esophageal proximal weak acid reflux (%), esophageal proximal acid reflux (%) and DeMmeester score in the study group were significantly lower than those before treatment and control group after treatment (P＜0.05); The high-resolution esophageal manometry analysis showed that after the treatment the two group were equally improved resting pressure of lower esophageal sphincter (LES), resting pressure of upper esophageal sphincter (UES) and score of distal esophageal contraction (DCI)(P＜0.05); After treatment, the curative effect of the study group was significantly higher than that of the control group (P＜0.05); the invalid rate of the study group was significantly lower than that of the control group (P＜0.05); the total effective rate of the study group was significantly higher than that of the control group (P＜0.05).

Conclusion

The combined therapy is effective and safe in the treatment of GERD with AF, by acid suppression, esophageal motility, symptoms and atrial fibrillation.

Key words: Gastroesophageal reflux disease, Atrial fibrillation, Acid inhibition, Heart rate, Efficacy

Maimaitiaili Aizezi, Maimaiti·Yisireyili, Yukui Du, Jinjie Shao, Jun Liu, Zonggang Zhang, Kelimu·Abudureyimu. The mechanistic study of inflammatory response mediated atrial fibrillation induced by gastroesophageal reflux disease[J]. Chinese Journal of Gastroesophageal Reflux Disease(Electronic Edition), 2022, 09(01): 23-29.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://zhwsgflbdzzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.2095-8765.2022.01.005

https://zhwsgflbdzzz.cma-cmc.com.cn/EN/Y2022/V09/I01/23

Figures/Tables 7

组别	例数	性别（男性/女性）	年龄（岁， $x ¯$ ±s）	BMI （kg/m²）	病程（年， $x ¯$ ±s）	合并高血压［例（%）］	合并冠心病［例（%）］	合并糖尿病［例（%）］
对照组	42	24/18	51.85±8.07	26.50±3.02	3.44±0.87	11（26.19）	13（30.95）	8（19.05）
研究组	45	25/20	54.95±7.97	25.37±2.89	3.63±0.71	13（28.89）	15（33.33）	10（22.22）
χ²/t值		0.022	-1.800	1.769	-1.096	0.079	0.056	0.133
P值		0.881	0.075	0.080	0.276	0.778	0.812	0.715

组别	例数	性别（男性/女性）	年龄（岁， $x ¯$ ±s）	BMI （kg/m²）	病程（年， $x ¯$ ±s）	合并高血压［例（%）］	合并冠心病［例（%）］	合并糖尿病［例（%）］
对照组	42	24/18	51.85±8.07	26.50±3.02	3.44±0.87	11（26.19）	13（30.95）	8（19.05）
研究组	45	25/20	54.95±7.97	25.37±2.89	3.63±0.71	13（28.89）	15（33.33）	10（22.22）
χ²/t值		0.022	-1.800	1.769	-1.096	0.079	0.056	0.133
P值		0.881	0.075	0.080	0.276	0.778	0.812	0.715

组别	GERD评分（分）		食管近端弱酸反流（%）		食管近端酸反流（%）		DeMeester评分（分）
组别	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
对照组	15.57±2.50	10.22±1.48^a	63.85±11.99	51.09±6.57^a	81.80±8.29	73.97±6.04^a	41.42±6.02	23.54±3.90^a
研究组	16.51±2.01	7.47±1.07^bc	66.20±9.51	39.91±5.12^bc	79.64±9.20	59.67±7.03^bc	39.84±5.02	15.37±2.56^bc
t值	-1.935	9.953	-1.013	8.892	1.149	10.143	1.336	11.619
P值	0.056	0.000	0.314	0.000	0.254	0.000	0.185	0.000

组别	UES静息压（mmHg）	LES静息压（mmHg）	CFV（cm/s）	IBP（mmHg）	DCI（mm Hg·cm·s）
对照组
治疗前	104.59±10.39	14.38±2.67	6.82±2.34	1500±2.07	1068.76±98.78
治疗后	90.28±8.84	17.88±3.85	6.43±1.66	14.59±2.20	1143.73±130.21
t值	9.381	-5.166	1.134	0.941	-3.199
P值	0.000	0.000	0.263	0.352	0.003
研究组
治疗前	101.64±10.87	12.36±2.04	6.44±1.10	14.39±2.43	1065.13±112.58
治疗后	61.44±8.01^ab	26.86±4.42^ab	6.56±1.42	13.58±2.16	1127.33±118.65^ab
t值	21.884	-20.642	-0.464	1.579	-2.896
P值	0.000	0.000	0.645	0.121	0.006

组别	心率（次/min）		QTd（ms）
组别	治疗前	治疗后	治疗前	治疗后
对照组	101.40±12.64	76.02±6.79^a	63.61±9.84	50.33±5.34^a
研究组	100.86±8.55	66.13±7.08^bc	65.75±7.77	46.91±6.53^b
t值	0.234	6.639	-1.128	2.664
P值	0.816	0.000	0.263	0.009

组别	SBP（mmHg）	DBP（mmHg）	PCWP（mmHg）	MPAP（mmHg）	CI［L/（min·m）］
对照组
治疗前	135.55±13.01	95.54±6.97	16.10±2.33	22.52±3.33	3.29±0.64
治疗后	125.24±8.46^a	79.09±4.28^a	15.55±2.38	22.20±4.35	3.43±0.67
t值	4.119	13.482	1.058	0.475	-1.115
P值	0.000	0.000	0.296	0.637	0.271
研究组
治疗前	134.26±12.42	97.04±5.99	14.43±2.51	22.10±4.38	3.20±0.64
治疗后	127.48±11.34^b	74.93±4.19^b	14.13±2.67	21.94±5.01	3.34±1.18
t值	2.574	21.529	0.673	0.175	-0.760
P值	0.014	0.000	0.505	0.862	0.451

组别	CRP（pg/ml）		IL-6（pg/ml）		TNF-α（pg/ml）
组别	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
对照组	64.30±8.06	42.83±4.85^a	37.26±2.76	26.37±4.46^a	55.80±6.78	30.13±4.87^a
研究组	66.84±7.60	29.62±6.64^bc	36.54±3.07	13.70±5.14^bc	56.42±5.65	20.44 ±4.40^bc
t值	-1.509	10.530	1.149	12.228	-0.459	9.747
P值	0.135	0.000	0.254	0.000	0.647	0.000

组别	例数	显效	有效	无效	总有效率
对照组	42	14（33.33）	20（47.62）	8（19.05）	34（80.95）
研究组	45	23（48.89）^a	19（44.44）	3（6.67）^a	42（93.33）^a
Z值		-1.994
P值		0.046

References 20

1	Kurin M, Fass R. Management of gastroesophageal reflux disease in the elderly patient [J]. Drugs Aging, 2019, 36(12): 1073-1081.
2	Zhou Q, Chen B, Chen X, et al. Arnebiae Radix prevents atrial fibrillation in rats by ameliorating atrial remodeling and cardiac function [J]. J Ethnopharmacol, 2020, 248,112317.
3	刘富伟, 黄琳, 俞建华, 等. 胃食管反流病与心房颤动发生及干预治疗的研究进展[J]. 中华心血管病杂志,2017, 45(3): 250-252.
4	肖正华, 卢晨, 项蒙蒙, 等. 中国心房颤动诊疗指南的质量评价[J]. 中国循证医学杂志, 2019, 19(2):77-82.
5	Maruyama T, Fukata M, Akashi K. Association ofatrial fibrillationand gastroesophageal refluxdisease: Natural and therapeutic linkage of the two commondiseases[J]. J Arrhythm, 2018, 35(1):43-51.
6	林运, 张成, 克力木, 等. 胃食管反流病是否会引发心房纤颤[J/OL]. 中华胃食管反流病电子杂志, 2015, 2(1):51-53.
7	Ghisa M, Della Coletta M, et al. Updates in the field of non-esophageal gastroesopha geal refluxdisorder [J]. Expert Rev Gastroenterol Hepatol, 2019, 13(9):827-838.
8	Floria M, Barboi O, Rezus C, et al. Atrial fibrillation and gastro-oesophageal reflux disease controversies and challenges [J]. Curr Pharm Des, 2015, 21(26): 3829-34.
9	买买提艾力·艾则孜, 买买提·依斯热依力, 张总刚, 等. 胃食管反流病与心房颤动的研究进展[J/OL]. 中华胃食管反流冰电子杂志, 2019, 6(2):97-100.
10	陈阿娣. 盐酸胺碘酮治疗冠心病室性心律失常的临床效果分析[J]. 中国实用医药,2017, 12(3):91-92.
11	Lee DK, Kim YJ, Kim G, et al. Impact of early intravenous amiodarone administration on neurological outcome in refractory ventricular fibrillation: retrospective analysis of prospectively collected prehospital data [J]. Scand J Trauma Resusc Emerg Med, 2019, 27(1): 109.
12	尚开亚, 关玲云, 罗文, 等. 盐酸美心律片与盐酸胺碘酮片治疗老年冠心病并发快速心律失常的疗效对比[J]. 河北医药, 2017, 39(12):1799-1801.
13	孙安修, 成宏伟, 吕建峰, 等. 三级医院医生对质子泵抑制剂认知水平的评价[J]. 中国医师杂志, 2019, 21(7):1043-1047.
14	Dantas RO, Cassiani RA. Upper esophageal sphincter dysfunction in gastroesophageal reflux disease [J]. Dysphagia, 2019, 34(6): 942-943.
15	尚琪, 郭丽芳, 张翠霞, 等. 质子泵抑制剂临床应用新领域[J]. 胃肠病学, 2017, 22(11):696-699.
16	Lin S, Li H, Fang X. Esophageal motor dysfunctions in gastroesophageal reflux disease and therapeutic perspectives [J]. J Neurogastroenterol Motil, 2019, 25(4): 499-507.
17	Kristo I , Paireder M , Jomrich G, et al. Modern esophageal function testing and gastroesophageal reflux disease in morbidly obese patients[J]. Obes Surg, 2019, 29(11): 3536-3541.
18	崔丽, 李广平, 刘彤. 胃食管反流病与心房颤动[J]. 江苏实用心电学杂志, 2016, 25(4):294-297.
19	买买提艾力·艾则孜, 买买提·依斯热依力, 张总刚, 等. 炎症反应介导胃食管反流病诱发心房颤动的机制研究[J].中国心血管病研究杂志, 2019, 17(4): 345-350.
20	Huang TC, Lo LW, Yamada S, et al. Gastroesophageal reflux disease and atrial fibrillation: Insight from autonomic cardiogastric neural interaction [J]. J Cardiovasc Electrophysiol, 2019, 30(11): 2262-2270.

[1]	Danni Liu, Meng Ao, Haitao Ran, Shiyu Li, Fang Qin. Biatrial structure and function reverse remodelling in patients with persistent atrial fibrillation after cardioversion: evidence from three dimensional echocardiography and two dimensional speckle tracking imaging [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(08): 827-835.
[2]	Hua Zhang, Yu Sun, Shijian Xiang, Yingmei Li, Xiaoqun Wang. Research on chemosensitivity evaluation using circulating tumor cells in advanced gastrointestinal cancer [J]. Chinese Archives of General Surgery(Electronic Edition), 2023, 17(06): 422-425.
[3]	Qingqing Zhu, Zhenqi Wei. Application value of self-efficacy management during perioperative period in patients with inguinal hernia [J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2023, 17(06): 773-777.
[4]	Hongmin Wang, Yunbo Xie, Yanhu Wang, Fusheng Wang. The advance of clinical research in mesenchymal stem cell treatment for COVID-19 [J]. Chinese Journal of Cell and Stem Cell(Electronic Edition), 2023, 13(04): 247-256.
[5]	Ruiqi Gu, Hongsheng Fang, Guoxiang Cai. Application and progress of circulating tumor DNA detection technology in the diagnosis and treatment of colorectal cancer [J]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2023, 12(06): 453-459.
[6]	Wenlong Liang, Jie Cao, Qing Huang, Yong Lin, Hongli Huang, Ping Yang, Guanwei Li, He Hu. Efficacy and safety analysis of sintilimab combined with regofenib in the treatment of advanced colorectal cancer [J]. Chinese Journal of Digestion and Medical Imageology(Electronic Edition), 2023, 13(06): 409-413.
[7]	Lijiao Jiang, Feng Zhang, Yuping Zhou. Clinical efficacy observation of treating elderly patients with acute non-variceal upper gastrointestinal hemorrhage using the MDT model [J]. Chinese Journal of Digestion and Medical Imageology(Electronic Edition), 2023, 13(06): 520-524.
[8]	Jingxu Zhang, Defang Li, Shangke You, Yutian Zhang. Clinical efficacy of bevacizumab and anlotinib combined with oxaliplatin in the treatment of advanced rectal cancer [J]. Chinese Journal of Digestion and Medical Imageology(Electronic Edition), 2023, 13(05): 289-293.
[9]	Jing Sheng, Yong Mei, Pei Xia, Xiaolin Wang. Clinical study of second-line treatment of advanced gastric cancer with ubenimex combined with irinotecan [J]. Chinese Journal of Digestion and Medical Imageology(Electronic Edition), 2023, 13(05): 317-321.
[10]	Xiaodong Yu, Dehua Li, Shan Gao, Xin Xu. Clinical observation on the treatment of mild active Crohn′s disease by combining Jiawei Lizhong Decoction with mesalazine [J]. Chinese Journal of Digestion and Medical Imageology(Electronic Edition), 2023, 13(04): 199-202.
[11]	Juan Zhang, Jiayan Zhuang, Yingmei Yang, Shengrong Jiang, Yan Su, Zhenxing Liu. Comparison of diagnostic efficacy of contrast-enhanced ultrasound and upper abdominal enhanced magnetic resonance in patients with hepatic hemangioma [J]. Chinese Journal of Digestion and Medical Imageology(Electronic Edition), 2023, 13(04): 220-223.
[12]	Jun Dong, Fangfang Wu. Clinical efficacy and safety analysis of mFOLFOX6 and FOLFOX4 chemotherapy regimens in the treatment of rectal cancer [J]. Chinese Journal of Digestion and Medical Imageology(Electronic Edition), 2023, 13(04): 236-240.
[13]	Jun Zhao, Chaojie Li, Jia Li. Curative effect of rabeprazole combined with Kangfuxin solution on duodenal ulcer with positive Helicobacter pylori infection [J]. Chinese Journal of Digestion and Medical Imageology(Electronic Edition), 2023, 13(04): 254-258.
[14]	Yingqian Li, Huashan Li. Evaluation of treatment methods for complete rectal prolapse: a real world study [J]. Chinese Journal of Clinicians(Electronic Edition), 2023, 17(06): 700-705.
[15]	Chengyu Li, Lianping Xu, Shengsong Wang, Qun Wang. The retention rate and efficacy analysis of different anti-seizure medication monotherapy in post-stroke epilepsy [J]. Chinese Journal of Cerebrovascular Diseases(Electronic Edition), 2023, 17(04): 325-330.

Please choose a citation manager

Content to export