Evaluation of QT and P Wave Dispersion and Mean Platelet Volume among Inflammatory Bowel Disease Patients

Abstract

Background: In inflammatory bowel disease (IBD) number of thromboembolic events are increased due to hypercoagulupathy and platelet activation. Increases in mean platelet volume (MPV) can lead to platelet activation, this leads to thromboembolic events and can cause acute coronary syndromes. In IBD patients, QT-dispersion and P-wave dispersion are predictors of ventricular arrhythmias and atrial fibrilation; MPV is accepted as a risk factor for acute coronary syndromes, we aimed at evaluating the correlations of these with the duration of disease, its localization and activity.Methods: The study group consisted of 69 IBD (Ulcerative colitis n: 54, Crohn's Disease n:15) patients and the control group included 38 healthy individuals. Disease activity was evaluated both endoscopically and clinically. Patients with existing cardiac conditions, those using QT prolonging medications and having systemic diseases, anemia and electrolyte imbalances were excluded from the study. QT-dispersion, P-wave dispersion and MPV values of both groups were compared with disease activity, its localization, duration of disease and the antibiotics used.Results: The P-wave dispersion values of the study group were significantly higher than those of the control group. Duration of the disease was not associated with QT-dispersion, and MPV levels. QT-dispersion, P-wave dispersion, MPV and platelet count levels were similar between the active and in mild ulcerative colitis patients. QT-dispersion levels were similar between IBD patients and the control group. No difference was observed between P-wave dispersion, QT-dispersion and MPV values; with regards to disease duration, disease activity, and localization in the study group (p>0.05).Conclusions: P-wave dispersion which is accepted as a risk factor for the development of atrial fibirilation was found to be high in our IBD patients. This demonstrates us that the risk of developing atrial fibrillation may be high in patients with IBD. No significant difference was found in the QT-dispersion, and in the MPV values when compared to the control group.

Assessment of Atrial Electromechanical Delay and Left Atrial Mechanical Functions in Patients with Ulcerative Colitis

“…Probable reasons for this inconsistency may include the following: only, patients with UC were included in our study, their study was not a prospective follow‐up study for AF development, and the number of active patients included in our study was too low. In a study by Yuksel et al evaluating ECG, P‐wave dispersion was shown to be increased in patients with IBD, and IBD was shown to be associated with AF . Although increased P‐wave dispersion values were detected in patients with UC in our study, the results were not statistically significant.…”

“…In a study by Yuksel et al evaluating ECG, P-wave dispersion was shown to be increased in patients with IBD, and IBD was shown to be associated with AF. 24 Although increased P-wave dispersion values were detected in patients with UC in our study, the results were not statistically significant.…”

Atrial Electromechanical Properties in Inflammatory Bowel Disease

“…There are relatively fewer studies on the relation between IBD and arrhythmias. One study that compared P‐wave dispersion on surface electrocardiography, which is considered as a risk factor for the development of AF, found that patients with IBD showed an increased P‐wave dispersion than controls . Another study showed AF prevalence found to be higher for all ages in IBD than in controls .…”

“…One study that compared P-wave dispersion on surface electrocardiography, which is considered as a risk factor for the development of AF, found that patients with IBD showed an increased P-wave dispersion than controls. 20 Another study showed AF prevalence found to be higher for all ages in IBD than in controls. 9 A recent nationwide cohort study consisting of 24 499 patients and 236 275 matched controls revealed that IBD was associated with twofold increased risk of AF during active disease stages independent of age, gender, and potential confounding factors and the risk of stroke was also elevated in patients with IBD during active stages like AF.…”

Prolonged P-Wave and QT Dispersion in Children with Inflammatory Bowel Disease in Remission

“…The literatures suggested that sympathetic activity changes could be the reason for QT and QTc interval alterations and increased QT dispersion and QTc dispersion of ventricular repolarisation [29, 30]. In contrast to these studies, Dogan et al did not find any significant difference in QTdisp values between 69 IBD patients and controls [27]. …”