To explore the correlation between gastroesophageal reflux disease and atrial fibrillation, acid reflux and esophageal motility

doi:10.3877/cma.j.issn.2095-8765.2024.01.007

Abstract

Abstract:

Objective

To investigate the relationship between gastroesophageal reflux disease and Atrial fibrillation, acid reflux and esophageal motility.

Methods

Retrospective analysis was conducted on patients with gastroesophageal reflux disease (GERD), Atrial fibrillation (AF) and suspected GERD combined with AF in the People's Hospital of Xinjiang from March 2022 to May 2023. According to the typical symptoms and diagnostic criteria of gastroesophageal reflux disease and Atrial fibrillation, patients were further divided into non GERD group (n=40), GERD group (n=40), AF group (n=40) and GERD combined with AF group (n=40). According to the sample size estimation formula, take the 95%CI and test the standard α= 0.05. Inspection efficiency 1-β=0.80 calculation requires 40 valid samples to be completed. The gastronesopgageal reflux disease questionnaire (GERD-Q) scale, Demesester system score, high resolution manometry (HRM), 24 h Holter monitor and gastroesophageal endoscopy were collected from four groups of patients.

Results

The analysis results showed that the GERD group and the GERD combined with AF group showed significant increases in GERD symptom score, proximal esophageal weak acid reflux (%), proximal esophageal acid reflux (%), and DeMeester score compared to the non GERD group (P<0.05); High resolution esophageal manometry analysis showed that, compared with the non GERD group, the resting pressure of the upper Sphincter (UES), the resting pressure of the low esophageal sphincter (LES) and the distal esophageal contraction integral (DCI) of GERD group and GERD with AF group decreased significantly (P<0.05); The heart rate and QT dispersion (QTd) levels in the GERD group, AF group, and GERD combined with AF group were significantly higher than those in the non GERD group (P<0.05), and the heart rate levels in the non GERD group were significantly lower than those in the GERD group (P<0.05); The arterial blood pressure (SBP, DBP) levels in the GERD group, AF group, and GERD combined with AF group were significantly higher than those in the non GERD group (P<0.05); The size of mucosal inflammation under gastroesophageal endoscopy in the GERD group and GERD combined with AF group was highly grater than non GERD group (P<0.01).

Conclusion

Atrial fibrillation, acid reflux and esophageal movement characteristics are significantly related to gastroesophageal reflux disease. GERD increases the incidence of Atrial fibrillation, significantly increases esophageal acid reflux, and changes esophageal movement characteristics.

Key words: Gastroesophageal reflux disease, Atrial fibrillation, Acid reflux, Esophageal motility characteristics

Wenyuan Yin, Yan Feng. To explore the correlation between gastroesophageal reflux disease and atrial fibrillation, acid reflux and esophageal motility[J]. Chinese Journal of Gastroesophageal Reflux Disease(Electronic Edition), 2024, 11(01): 31-36.

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References 27

1	Linz D, Hohl M, Vollmar J, et al. Atrial fibrillation and gastroesophageal reflux disease: the cardiogastric interaction[J]. Europace, 2017, 19(1):16-20.
2	Mohamed A, Ochoa Crespo D, Kaur G, et al. Gastroesophageal reflux and its association with atrial fibrillation: a traditional review[J]. Cureus, 2020, 12(9):e10387.
3	何权瀛. 对于心房颤动、胃食管反流病和阻塞性睡眠呼吸暂停三者关系的认识[J]. 临床内科杂志,2020,37(4):313-316.
4	Jin H, Zhu K, Wang L, et al. Efficacy and safety of non-vitamin K anticoagulants for atrial fibrillation in relation to different renal function levels: a network meta-analysis[J]. Cardiovasc Ther, 2020, 2020:2683740.
5	中华医学会消化病学分会. 2020年中国胃食管反流病专家共识[J]. 中华消化杂志, 2020, 40(10): 649-663.
6	Turagam MK, Flaker GC, Velagapudi P, et al. Atrial fibrillation in athletes: pathophysiology, clinical presentation, evaluation and management[J]. J Atr Fibrillation, 2015, 8(4):1309.
7	Maruyama T, Fukata M, Akashi K. Association of atrial fibrillation and gastroesophageal reflux disease: Natural and therapeutic linkage of the two common diseases[J]. J Arrhythm, 2018, 35(1):43-51.
8	买买提·依斯热依力, 阿孜古丽·阿力木江, 李义亮, 等. NADPH氧化酶-4和酸敏感受体在心理应激小鼠食管中的表达及作用[J]. 中国医师杂志, 2020, 22(7): 1000-1004.
9	Coutinho EL, Herbella FAM, Lovato CAV, et al. Objective evaluation of gastroesophageal reflux disease in patients with paroxysmal atrial fibrillation[J]. World J Surg, 2018, 42(5):1458-1462..
10	Malik V, Lau DH, Linz D, et al. Is the stomach a way to one's heart? Gastric autonomic activity and AF susceptibility in gastroesophageal reflux disease[J]. J Cardiovasc Electrophysiol, 2019, 30(11): 2271- 2273.
11	吴俊, 曾龙欢, 郑永科, 等.老年心房颤动患者合并胃食管反流病的现状及临床症状的调查[J]. 浙江临床医学,2016(1):71-72.
12	Xu L, Zhang Y, Xie J, et al. Association between gastroesophageal reflux disease and atrial fibrillation: a systematic review and meta-analysis[J]. Rev Esp Enferm Dig, 2019, 111(11):874-879.
13	李金贤, 程新春. 胃食管反流病合并心房颤动患者的临床特点及危险因素[J/OL]. 中华胃食管反流病电子杂志,2022, 9(1):6-11.
14	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]. 中华胃食管反流病电子杂志, 2019, 6(2):97-100.
15	Adukauskaite A, Stühlinger M. Vorhofflimmern beim sportler: häufigkeit, diagnose und therapie [Atrial fibrillation in athletes: prevalence, diagnosis, and treatment][J]. Herzschrittmacherther Elektrophysiol, 2023, 34(1):39-44. German.
16	Floria M, Bărboi O, Grecu M, et al. Atrial fibrillation and sympathovagal balance in patients with gastroesophageal reflux disease[J]. Turk J Gastroenterol, 2017, 28(2):88-93.
17	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.
18	Jiang Y, Damiris K, Suero-Abreu G, et al. Reflux esophagitis is associated with higher risks of acute stroke and transient ischemic attacks in patients hospitalized with atrial fibrillation: A nationwide inpatient sample analysis[J]. Medicine (Baltimore), 2021, 100(25):e26502.
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	Armaganijan L, Patel D, Lopes RD, et al. Gastroesophageal reflux and atrial fibrillation: is there any correlation? [J].Expert Rev Cardiovasc Ther, 2012, 10(3):317-22.
21	买买提艾力·艾则孜, 买买提·依斯热依力, 杜宇奎, 等. 胃食管反流病合并房颤患者采用盐酸胺碘酮联合艾司奥美拉唑治疗效果及对炎症因子的影响[J/OL]. 中华胃食管反流病电子杂志,2022, 9(1):23-29.
22	亚力坤·吐尔洪, 买买提·依斯热依力, 克力木·阿不都热依木.胃食管反流病发病分子机制研究进展[J]. 中国医师杂志,2022,24(9):1425-1428.
23	Lin K, Chen X, Zhang L, et al. Proton pump inhibitors as also inhibitors of atrial fibrillation[J]. Eur J Pharmacol, 2013, 718(1-3):435-440.
24	Hwang JJ, Lee DH, Yoon H, et al. Is Atrial fibrillation a risk factor for gastroesophageal reflux disease occurrence?[J] Medicine (Baltimore), 2015, 94(43): e1921.
25	买买提·依斯热依力, 赵新胜, 艾克拜尔·艾力, 等. 慢性束缚应激对小鼠食管上皮细胞间距增宽及炎症发生的研究[J/OL]. 中华胃食管反流病电子杂志,2019,6(4):182-187.
26	Turagam MK, Flaker GC, Velagapudi P, et al. Atrial fibrillation in athletes: pathophysiology, clinical presentation, evaluation and management[J]. J Atr Fibrillation, 2015, 8(4):1309.
27	Velagapudi P, Turagam MK, Leal MA, et al. Atrial fibrillation and acid reflux disease[J]. Clin Cardiol, 2012, 35(3):180-186.

组别	例数	性别 (男性/女性)	年龄 (岁, )	BMI (kg/m², )	病程 (个月, )
非GERD组	40	17/23	55.60±7.07	26.01±3.21	3.25±1.02
GERD组	40	21/19	55.57±6.56	26.42±4.05	3.20±0.91
AF组	40	22/18	57.22±7.04	27.81±4.27	3.52±1.17
GERD合并AF组	40	16/24	56.92±6.88	25.96±3.85	3.70±1.34
X²/F值		2.607	0.634	2.003	1.533
P值		0.456	0.594	0.116	0.208

组别	例数	性别 (男性/女性)	年龄 (岁, )	BMI (kg/m², )	病程 (个月, )
非GERD组	40	17/23	55.60±7.07	26.01±3.21	3.25±1.02
GERD组	40	21/19	55.57±6.56	26.42±4.05	3.20±0.91
AF组	40	22/18	57.22±7.04	27.81±4.27	3.52±1.17
GERD合并AF组	40	16/24	56.92±6.88	25.96±3.85	3.70±1.34
X²/F值		2.607	0.634	2.003	1.533
P值		0.456	0.594	0.116	0.208

组别	例数	GERD症状评分（分）	食管近端弱酸反流(%)	食管近端酸反流(%)	DeMeester评分（分）
非GERD组	40	8.32±1.23	45.37±4.09	3.46±1.07	12.47±2.11
GERD组	40	13.30±1.93^a	63.25±5.13^a	25.60±3.45^a	41.32±6.81^a
AF组	40	7.43±1.15	46.02±4.29	4.56±1.78	14.10±2.43
GERD合并AF组	40	14.55±2.14^a,b	67.82±8.36^a,b	32.43±4.87^a,b	48.47±10.05^a,b
F值		156.000	163.835	909.664	346.839
P值		0.000	0.000	0.000	0.000

组别	例数	GERD症状评分（分）	食管近端弱酸反流(%)	食管近端酸反流(%)	DeMeester评分（分）
非GERD组	40	8.32±1.23	45.37±4.09	3.46±1.07	12.47±2.11
GERD组	40	13.30±1.93^a	63.25±5.13^a	25.60±3.45^a	41.32±6.81^a
AF组	40	7.43±1.15	46.02±4.29	4.56±1.78	14.10±2.43
GERD合并AF组	40	14.55±2.14^a,b	67.82±8.36^a,b	32.43±4.87^a,b	48.47±10.05^a,b
F值		156.000	163.835	909.664	346.839
P值		0.000	0.000	0.000	0.000

组别	例数	UES静息压 (mmHg)	LES静息压 (mmHg)	CFV (cm/s)	IBP (mmHg)
非GERD组	40	98.30±9.96	18.22.±3.06	7.17±1.35	14.30±1.96
GERD组	40	47.57±9.16	8.65±1.74	6.94±1.48	15.00±1.82
AF组	40	83.22±9.140^ab	21.80±4.18	6.76±1.41	13.92±1.90
GERD合并AF组	40	53.57±6.84	8.32±1.80	6.95±1.67	14.20±2.31
F值		314.253	223.647	0.512	2.075
P值		0.000	0.000	0.674	0.106

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