Yamak Betül Ayça, Güven İbrahim Ethem, Candemir Mustafa
Department of Cardiology, Hopa State Hospital, 08600 Artvin, Turkey.
Department of Gastroenterology, Yenimahalle Education and Research Hospital, 06370 Ankara, Turkey.
Diagnostics (Basel). 2025 Jan 15;15(2):187. doi: 10.3390/diagnostics15020187.
The impact of Celiac Disease (CD) is not only limited to the intestinal system, but extraintestinal manifestations may also be seen. In this context, cardiac manifestations have recently been the focus of attention. This study aimed to evaluate myocardial repolarization properties in CD patients by assessing the frontal QRS-T Angle (fQRS-T) on electrocardiography (ECG). A total of 302 patients, including 150 CD patients and 152 control group patients, were included in the study. ECG parameters, including fQRS-T, QRS interval, and QTc interval, were calculated for each patient and compared between the groups. In addition, the relationship of these ECG parameters with disease duration was also analyzed. The median disease duration was 38.5 (16 to 96) months in the CD group. Significantly wider QRS interval (92 (86 to 96) vs. 83 (76.3 to 93), < 0.001) and fQRS-T (23 (13 to 37) vs. 18 (6.3 to 27), < 0.001) values were observed in the CD group. Among CD patients, those with longer disease duration (>38.5 months) exhibited significantly wider QRS intervals (94 (88 to 98) vs. 88 (84 to 94), < 0.001) and frontal QRS-T angles (29 (14 to 47) vs. 16 (10 to 25), < 0.001) compared to those with shorter disease duration. A positive correlation between the disease duration and fQRS-T was also demonstrated (r = 0.478, < 0.001). Multivariable logistic regression identified QRS interval (OR: 1.060, 95% CI: 1.032-1.088, < 0.001) and frontal QRS-T angle (OR: 1.028, 95% CI: 1.013-1.043, < 0.001) as independent predictors of CD. Additionally, the QRS interval (OR: 1.066, 95% CI: 1.012-1.124, = 0.016) and frontal QRS-T angle (OR: 1.021, 95% CI: 1.003-1.038, = 0.021) were significant predictors of longer disease duration. A linear regression analysis confirmed that disease duration was a stronger predictor of frontal QRS-T angle widening (B: 0.389, 95% CI: 0.102-0.677, < 0.001) compared to age (B: 0.184, 95% CI: 0.123-0.245, = 0.008). In this study, we demonstrated that chronic inflammation secondary to CD may have negative effects on cardiac repolarization and that this effect is closely related to disease duration.
乳糜泻（CD）的影响不仅局限于肠道系统，还可能出现肠外表现。在此背景下，心脏表现最近成为关注焦点。本研究旨在通过评估心电图（ECG）上的额面QRS-T角（fQRS-T）来评价CD患者的心肌复极特性。该研究共纳入302例患者，其中包括150例CD患者和152例对照组患者。计算了每位患者的ECG参数，包括fQRS-T、QRS间期和QTc间期，并在两组之间进行比较。此外，还分析了这些ECG参数与疾病持续时间的关系。CD组的疾病持续时间中位数为38.5（16至96）个月。CD组观察到QRS间期（92（86至96）对83（76.3至93），<0.001）和fQRS-T（23（13至37）对18（6.3至27），<0.001）值明显更宽。在CD患者中，疾病持续时间较长（>38.5个月）的患者与疾病持续时间较短的患者相比，QRS间期（94（88至98）对88（84至94），<0.001）和额面QRS-T角（29（14至47）对16（10至25），<0.001）明显更宽。疾病持续时间与fQRS-T之间也显示出正相关（r = 0.478，<0.001）。多变量逻辑回归确定QRS间期（OR：1.060，95%CI：1.032 - 1.088，<0.001）和额面QRS-T角（OR：1.028，95%CI：1.013 - 1.043，<0.001）是CD的独立预测因素。此外，QRS间期（OR：1.066，95%CI：1.012 - 1.124，= 0.016）和额面QRS-T角（OR：1.021，95%CI：1.003 - 1.038，= 0.021）是疾病持续时间较长的显著预测因素。线性回归分析证实，与年龄（B：0.184，95%CI：0.123 - 0.245，= 0.008）相比，疾病持续时间是额面QRS-T角增宽的更强预测因素（B：0.389，95%CI：0.102 - 0.677，<0.001）。在本研究中，我们证明CD继发的慢性炎症可能对心脏复极有负面影响，且这种影响与疾病持续时间密切相关。
