Does GERD Affect the Heart?
Gastroesophageal reflux disease (GERD) may contribute toischemic chest pain through acid-induced vasoconstriction andcompromised coronary perfusion. In the September 2005, issue ofthe International Journal of Cardiology, Slawomir Dobrzycki andcolleagues reported on the influence of omeprazole on ischemiain patients with GERD and coronary artery disease (CAD).
Patients (n = 50) with CAD underwent esophageal pH monitoringfor 24 hours. During that time, the number of ST-segmentdepression episodes and the total duration of ischemic episodes,expressed as total ischemic burden (TIB), were assessed.Esophageal pH and the number of pathologic refluxes (PRs) weredetermined using pH-metry.
Patients fulfilling the GERD criteria (46%) received omeprazoletherapy (20 mg bid) for 7 days. Of the 218 episodes of ST-segmentdepression, 45 (20.6%) were correlated with PRs. GERD patientshad larger TIBs and more ST-segment depressions (P <.015 andP <.035, respectively). Omeprazole therapy reduced all parametersof esophageal pH monitoring (P <.0022), as well as the number ofST-segment depressions (P <.012) and TIBs (P <.05). Short-termomeprazole therapy restored normal esophageal pH and significantlyreduced myocardial ischemia in patients with GERD and CAD.