title: [Ischemic heart disease and gastro-oesophageal reflux disease--simultaneous 24 monitoring of ECG and oesophageal pH].
abstract: OBJECTIVE
  To determine the correlation between episodes of ischaemia in ECG recordings with pathologic gastro-esophageal reflux during simultaneous 24 hour monitoring of ECG and oesophageal pH.
  
  
  METHODS
  Simultaneous 24 hour monitoring of ECG and oesophageal pH was performed in 30 patients (p) (26 M/4F, aged 39-74) with coronary artery disease of CCS class II-III, CAD was confirmed in coronary angiography. Analysis of the oesophageal pH was performed by using the Polygram programme (PW-version 2.04 Esophogram-version 2.01). ST depression > 1 mm and lasting at least 1 min was regarded as significant in ECG monitoring. Pathologic gastro-esophageal reflux was defined as a drop in pH < 4 lasting more than 5 min. Gastrooesophageal reflux disease (GERD) was diagnosed when a drop in pH < 4 lasted for more than 5% of the monitoring period. Gastro-oesophageal reflux dependent ST depression was defined as an ST depression that occurred during reflux episode and lasted up until 10 min from the end of the reflux.
  
  
  RESULTS
  26 patients (87%) had a total of 116 episodes of ST depression and 21 out of the 116 episodes (18%) were Gastro-oesophageal reflux time dependent. Fifteen patients (50%), had at least one episode of ST depression, depending on the time of reflux. Pathologic gastro-esophageal reflux was present in 25 patients (85%). In 14 patients (46.6%), the GERD pH criteria were fulfilled. In this group of patients, there was a significantly longer time of total ST depression (total ischaemic burden).
  
  
  CONCLUSIONS
  1. GERD is a frequent disease in patients with angiographically proven coronary artery disease. 2. Pathological gastroesophageal reflux can induce myocardial ischaemia, which can be determined by analysis of ST depression during 24 hour monitoring of ECG.
authors.affiliation: Zakład Kardiologii Inwazyjnej AM 15-276 Białystok ul. M. Skłodowskiej-Curie 24A. proprzem@yahoo.com
authors.forename: Sławomir
authors.initials: S
authors.lastname: Dobrzycki
authors.forename: Andrzej
authors.initials: A
authors.lastname: Baniukiewicz
authors.forename: Włodzimierz J
authors.initials: WJ
authors.lastname: Musiał
authors.forename: Dorota
authors.initials: D
authors.lastname: Skrodzka
authors.forename: Anna
authors.initials: A
authors.lastname: Zaremba-Woroniecka
authors.forename: Janusz
authors.initials: J
authors.lastname: Korecki
authors.forename: Wiktor
authors.initials: W
authors.lastname: Łaszewicz
authors.forename: Paweł
authors.initials: P
authors.lastname: Kralisz
authors.forename: Jan
authors.initials: J
authors.lastname: Paruk
authors.forename: Wacław
authors.initials: W
authors.lastname: Kochman
mesh_terms: D000328:Adult; D000368:Aged; D017023:Coronary Angiography; D015716:Electrocardiography, Ambulatory / Q000379:methods; D004947:Esophagus / Q000503:physiopathology*; D005260:Female; D005764:Gastroesophageal Reflux / Q000150:complications* / Q000503:physiopathology*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000150:complications* / Q000503:physiopathology*; D013997:Time Factors