Holter monitoring results in adolescents with chronic inflammatory pathology of the upper gastrointestinal tract
Authors: Krutenko N.V. , Shevchenko N.S. , Zimnytska T.V. , Voloshyn K.V. , Taranenko O.B. , Pavlova O.S. , Kvaratskheliya T.M. 
Published: November 2024

Background. Upper gastrointestinal tract (GIT) chronic disorders in adolescence may be accompanied by the cardiac complaints and electrophysiological changes in the myocardium. Considering of cardiovascular activity assessment modern methods and new way of gastrointestinal tract disease therapy management, heart functional state needs further clarification.

Purpose. Clarifying the nature and frequency of changes in the heart Holter ECG monitoring (HM ECG) in adolescents with chronic inflammatory pathology of the upper gastrointestinal tract and determining the significance of concomitant conditions (benign CSF hypertension syndrome, autonomic dysfunction syndrome, and undifferentiated connective tissue dysplasia) in relation to their occurrence.

Materials and methods. 69 adolescents with chronic inflammatory process of the GIT were examined. Control group included 36 children without GIT disorders. Presence of the most common concomitant diseases: benign intracranial hypertension syndrome (BIHS), autonomic dysfunction syndrome (ADS), undifferentiated connective tissue dysplasia (UCTD), were considered. Сardiovascular system examination, standard 12-channel resting ECG (electrocardiography), HM ECG considering the data of the well-being diary, heart echocardiographic examination (EchoCS) was provided for all patients.

Results. Тhe frequency of HM ECG changes was more common among adolescents with inflammatory diseases of the GIT patients compared to the peers of the control group (72.46% vs. 52.78, respectively, р < 0,05). Impaired impulse formation was observed in 71.01% of cases, the ST-T interval and T wave abnormalities were present in 60.87% of adolescents, combined rhythm disorders – in 13.04% of cases, cardiac conduction disorders – in 18.84%. Sinus tachycardia and combined rhythm disturbances were significantly more frequently detected among female patients (pj < 0.05). Impaired impulse formation was recorded significantly more often in children with gastroesophageal reflux disease (GERD) than in children with chronic gastritis (85.71% vs 65.91; p < 0.05). Arrhythmias were benign in 85.51% of cases. The frequency of their detection did not depend on the clinical variant of the gastrointestinal tract disease. The analysis results of the influence probability of concomitant diseases or their combination on the development of arrhythmias in patients did not reach the level of statistical significance (p > 0.05).

Conclusions. In adolescents with chronic diseases of the gastrointestinal tract, various bioelectrical ECG phenomena are more often registered. Among them, there is a violation of automatism, conduction and repolarization of the myocardium of the ventricles. Sinus tachycardia and combined rhythm disturbances were significantly more common in girls. Violation of the automated heart was more typical for patients with GERD. Unfavorable variants of arrhythmias were registered in 14.49% of teenagers. It was established that such concomitant conditions as benign CSF hypertension, autonomic dysfunction syndrome and undifferentiated connective tissue dysplasia do not have a significantly greater influence on the development of functional heart disorders in children with gastrointestinal tract pathology.