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[The characteristics of peptic ulcer in subjects with concomitant ischemic heart disease]
Insights
Coronary heart disease (CHD) patients frequently develop gastric ulcers, often without typical symptoms. Circulatory issues in the gastric mucosa, including hypoxia, are key factors in ulcer development and exacerbations.
Area of Science:
- Gastroenterology
- Cardiology
- Pathophysiology
Background:
- Coronary heart disease (CHD) is often associated with gastrointestinal issues.
- Gastric and duodenal ulcers present unique challenges in patients with concurrent CHD.
Purpose of the Study:
- To investigate the clinical presentation and underlying mechanisms of gastric and duodenal ulcers in patients with coronary heart disease.
- To identify factors contributing to ulcer exacerbations in this patient population.
Main Methods:
- Clinical examination and histological analysis of gastric/duodenal mucosa biopsies in 209 CHD patients with ulcers.
- Assessment of ulcer recurrence, exacerbation timing, and associated risk factors.
Main Results:
- Gastric ulcers were more common (56%) than duodenal ulcers in CHD patients, predominantly affecting males.
- Ulcers often presented with painless bleeding, frequent recurrences, and exacerbations coinciding with CHD events.
- Microcirculatory disorders, hypoxia, and dyslipidemia were identified as major contributors to ulcer exacerbations in 62% of patients.
Conclusions:
- Circulatory disorders in gastric mucosa, including hypoxia and trophic defects, are implicated in the pathogenesis of gastrointestinal ulcers in CHD patients.
- These findings highlight the critical role of mucosal blood flow and oxygenation in ulcer development and management within the context of cardiovascular disease.
Aim:
The study of clinical running of gastric or duodenal ulcer in associated coronary heart disease (CHD).
Materials And Methods:
209 CHD patients with gastric ulcer (GU) or duodenal ulcer (DU) were examined clinically plus histological examination of gastric or duodenal mucosa biopsies was made.
Results:
In CHD patients GU occurred more frequently (56%) than DU. The lesions involved more frequently lesser curvature of the stomach and pyloric part of the stomach. Males developed ulcers 3.5 times more frequently than females. Ulcers tended to a painless course without season exacerbations. The disease manifested first with gastric bleeding in 52% of the patients. GU and DU ran with frequent recurrences and long-term exacerbations (76% of patients) which coincided in time with CHD exacerbations. 68% of patients developed exacerbations within 10 days after myocardial infarction or aortocoronary bypass operation. Helicobacter pylori was present as a resolving factor in arising ulcer in 26% of patients. Microcirculatory disorders, reduced blood flow speed in gastric or duodenal mucosa, hypocoagulation syndrome, dyslipidemia provoked exacerbations in 62% of patients. Examinations of biopsies from gastric and duodenal mucosa showed marked dystrophic changes in the mucosa, its connective tissue basis in the vessels in the presence of mild inflammation at ulcer site.
Conclusion:
The onset of ulcers and erosions in the mucosa of the gastrointestinal tract in CHD may be due to circulatory disorders in gastric mucosa. The main factors of aggression are hypoxia, hypoxia-induced trophic defects in gastric and duodenal mucosa, circulatory disorders.