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Published on: June 21, 2016
Cardiac involvement in Crohn's disease: echocardiographic study
Gianpaolo Bragagni1, Raffaele Brogna, Paola Franceschetti
1Department of Internal Medicine, SS Annunziata Hospital, Cento (Ferrara), Italy.
Insights
Crohn's Disease (CD) frequently causes subclinical cardiac involvement, including morphologic alterations and pericardial effusion, which correlates with disease activity. Tumor necrosis factor-alpha may play a role in these cardiac changes.
Area of Science:
- Gastroenterology
- Cardiology
- Immunology
Background:
- Crohn's Disease (CD) often presents with extra-intestinal manifestations, though cardiac involvement is typically considered rare.
- This study investigates the prevalence and characteristics of cardiac involvement in CD patients.
Purpose of the Study:
- To assess cardiac involvement in Crohn's Disease patients.
- To explore correlations between cardiac findings and disease activity, duration, localization, and therapy.
Main Methods:
- Transthoracic echocardiogram with Doppler study was performed on 68 CD patients and 60 healthy controls.
- Cardiac morphology, valve function, and ejection fraction were evaluated.
Main Results:
- Significantly higher rates of morphologic alterations (69.11% vs 20.0%), mitral valve prolapse (29.4% vs 6.6%), and pericardial effusion (19.1% vs 1.6%) were observed in CD patients compared to controls.
- Pericardial effusion and decreased left ventricle ejection fraction were correlated with CD activity.
- No correlation was found between cardiac findings and age, sex, disease duration, therapy, or localization.
Conclusions:
- Crohn's Disease frequently leads to cardiac involvement, often remaining subclinical.
- Alterations in the cytokine network, such as elevated tumor necrosis factor-alpha, and increased oxidative stress may contribute to cardiac manifestations in CD.
Background:
Crohn's Disease (CD) commonly presents extra-intestinal manifestations, but cardiac involvement is considered rare. The aim of the present study was to assess cardiac involvement in CD and its possible correlation with activity, duration, localization and therapy.
Patients And Methods:
A group of 68 patients with CD and a control group of 60 healthy subjects were subjected to a transthoracic echocardiogram with Doppler study.
Results:
The study found overall morphologic alterations in 47/68 CD patients (69.11%) versus 12/60 controls (20.0%; P < 0.01); mitral valve prolapse in 20/68 CD patients (29.4%) versus 4/60 controls (6.6%; P < 0.01); and pericardial effusion in 13/68 CD patients (19.1%)versus 1/60 controls (1.6%; P < 0.01). The following findings were frequent, but without statistical significance: mitral insufficiency, 9/68 CD (13.2%) versus 3/60 controls (5.0%); tricuspidalic insufficiency, 8/68 CD (11.7%) versus 3/60 controls (5%); aortic insufficiency, 3/68 CD (4.4%) versus none in the control group; and decreased left ventricle ejection fraction, 5/68 CD (7.3%) versus none in the control group. Pericardial effusion was found to be related to CD activity (r = 0.375; P = 0.002) as well as decreased ejection fraction (r = 0.358; P = 0.003). No correlation with age, sex, duration, therapy or localization of disease was found.
Conclusions:
These findings suggest that CD frequently determines cardiac involvement, although it is usually subclinical. The alteration of cytokine network, especially the elevated levels of tumor necrosis factor-alpha, could be implicated in the cardiac alterations because it was observed, as for raised oxidative stress, in other heart diseases.
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