title: Further assessment of atrial fibrillation as a risk factor for gastroesophageal reflux disease: a multicenter questionnaire survey.
abstract: OBJECTIVE
  Although both atrial fibrillation (AF) and gastroesophageal reflux disease (GERD) are common diseases, the relationship between these two conditions remains controversial, depending on the study design and type of AF. Therefore, we focused on the relationship between nonvalvular AF and GERD.
  
  
  METHODS
  A total of 479 consecutive subjects (255 men and 224 women, mean age: 60.4 ± 12.8 years), including outpatients at several hospitals (n=201) and participants of an annual health screening program (n=278), were enrolled. Subjects with valvular AF, malignancy or dementia were excluded. The frequency scale for symptoms of GERD (F-scale) was applied after obtaining each patient's informed consent for screening symptomatic GERD with a total cutoff score of 8 points. The score on the questionnaire was correlated with the baseline characteristics extracted from the patients' medical records.
  
  
  RESULTS
  The total F-scale scores were significantly higher in the older patients (≥ 60 years) than in the younger patients (<60 years) (p=0.017) and increased in the following order: permanent AF > paroxysmal AF > sinus rhythm (p=0.003). The incidence of GERD increased in the same order among the patients with the various heart rhythm classifications (p<0.001). Coronary heart disease, hypertension, diabetes and dyslipidemia were not correlated with the F-scale scores or incidence of GERD. The stepwise discriminant analyses demonstrated that nonvalvular AF alone was significantly associated with symptomatic GERD (Wilks' lambda=0.983, p=0.004).
  
  
  CONCLUSIONS
  This multicenter study demonstrated that nonvalvular AF is significantly correlated with symptomatic GERD. This small sample survey warrants a future study of a large-scale cohort.
authors.affiliation: Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Japan.
authors.forename: Satoko
authors.initials: S
authors.lastname: Kubota
authors.forename: Gen
authors.initials: G
authors.lastname: Nakaji
authors.forename: Hideki
authors.initials: H
authors.lastname: Shimazu
authors.forename: Keita
authors.initials: K
authors.lastname: Odashiro
authors.forename: Toru
authors.initials: T
authors.lastname: Maruyama
authors.forename: Koichi
authors.initials: K
authors.lastname: Akashi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000150:complications* / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D005764:Gastroesophageal Reflux / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D010045:Outpatients; D012307:Risk Factors; D011795:Surveys and Questionnaires