Prolonged P-Wave and QT Dispersion in Children with Inflammatory Bowel Disease in Remission
Helen Aghdasi Bornaun1, Nuh Yılmaz2, Günsel Kutluk3
1Department of Pediatric Cardiology, Kanuni Sultan Süleyman Education and Research Hospital, İstanbul, Turkey.
Insights
Pediatric inflammatory bowel disease (IBD) patients show increased risks for cardiac arrhythmias, even in remission. This study found longer P-wave and QT interval dispersion in children with IBD, suggesting potential long-term heart conduction abnormalities.
Area of Science:
- Pediatric Cardiology
- Gastroenterology
- Electrophysiology
Background:
- Inflammatory bowel diseases (IBD), including ulcerative colitis (UC) and Crohn's disease (CD), are chronic conditions with unknown causes.
- Cardiac arrhythmias have been noted in adult IBD patients, prompting investigation into pediatric populations.
Purpose of the Study:
- To assess atrial conduction and ventricular repolarization abnormalities in pediatric IBD patients.
- To investigate P-wave and QT interval dispersion in children with IBD during remission.
Main Methods:
- Compared 36 pediatric IBD patients (UC: 20, CD: 16) with 36 age/sex-matched controls.
- Utilized 12-lead electrocardiograms to measure P-wave, QT, and corrected QT (QTc) interval dispersion.
- Performed transthoracic echocardiograms and 24-hour Holter monitoring.
Main Results:
- Pediatric IBD patients exhibited significantly longer P-wave dispersion, QT dispersion, and QTc interval dispersion compared to controls.
- Significant differences were observed in mean Pminimum, Pmaximum, and QTcminimum values between groups.
- Echocardiography and Holter results showed no significant differences between IBD patients and controls, or between UC and CD subgroups.
Conclusions:
- Pediatric IBD patients may be at increased risk for serious atrial and ventricular arrhythmias.
- These cardiac risks may persist even during periods of clinical remission.
- Further long-term monitoring is suggested for pediatric IBD patients.
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.
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