Cardiac pathologies in celiac patients

Celiac disease (CD) develops as a result of sensitivity to gluten in cereal products such as wheat, barley and rye in genetically predisposed individuals, causing inflammatory changes in the intestinal mucosa, ıt is an autoimmune and familial disease that shows clinical improvement with gluten-free diet. Cardiovascular complications in celiac disease are known to be one of the causes of morbidity and mortality. It has been seen that certain cardiovascular diseases such as cardiomyopathy, myocarditis, arrhythmias and early atherosclerosis are more common in individuals with CD than in individuals without the disease, and subclinical cardiovascular system involvement is observed more frequently than myocarditis and dilated cardiomyopathy. In our study, it was aimed to evaluate the effect of CD on the cardiovascular system in children. Our study included celiac patients who were followed up in the Fırat University Hospital Pediatric Gastroenterology Polyclinic as a patient group and who did not have an additional chronic disease, and children who applied to the Pediatric Cardiology Polyclinic for innocent murmur or sports report without CD and additional chronic disease, who were not found to have cardiac pathology in the physical examination and echocardiography (ECHO) as the control group. Demographic, laboratory, electrocardiography (ECG) and ECHO data of all children were recorded. Demographic, laboratory, ECG and ECHO data of celiac patients and control groups were compared. A total of 107 cases, 55 of whom were Celiac patients and 52 of whom were in the control group, were included in the study. The age of the patient group was 11(2-18) year, and the age of the control group was 15(2-17) year. All of the patients were diagnosed with the pathological examination performed after endoscopy, and the average follow up time was 3.7±2.9 years. In our study, children with CD had a shorter PR interval and higher heart rate, diastolic blood pressure (DBP), PR dispersion, QT dispersion, QTc dispersion and P ax compared to the control group. Again, it was determined that vitamin B12 was higher and vitamin D was lower in the patient group. While ECHO results in the control group were normal, mitral valve failure in one patient, tricuspid valve failure in one patient, patent ductus arteriosus in one patient, and mitral valve prolapse in four patients were detected in the patient group. And also, the left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVEDS), end-systolic volume (ESV), end-diastolic volume (EDV) and stroke volume (SV) were found to be lower in the patient group as per the control group. In the diet-compliant group, DBP, low-density lipoprotein (LDL) and P ax were found to be lower than the non-adherent group. Cardiovascular pathologies and subclinical findings are more common in children with CD than in healthy children. Key words: Arrhythmia, cardiovascular involvement, celiac disease, ECG