Acid Reflux Research Today is a free monthly online journal that collates and summarizes the latest research about Acid Reflux, including details on diet, gerd (gastro-esophageal reflux disease), treatment, symptoms.

The evaluation of gastro-oesophageal reflux and oesophagocardiac reflex in patients with angina-like chest pain following cardiologic investigations.

Rosztóczy A, Vass A, Izbéki F, Nemes A, Rudas L, Csanády M, Lonovics J, Forster T, Wittmann T

First Department of Medicine, Albert Szent-Györgyi Medical, Centre, University of Szeged, Hungary. air@in1st.szote.u-szeged.hu

The aims of the study were to assess pathogenetic role of gastro-oesophageal reflux and the oesophago-cardiac reflex in subjects with chest pain. To evaluate the prevalence of gastro-oesophageal reflux disease and the oesophago-cardiac reflex in patients with different coronary artery diseases and in coronary spasm. PATIENTS, METHODS: Fifty-one patients with chest pain were enrolled after detailed cardiologic evaluation including coronary angiography. The prevalence of gastrooesophageal reflux disease was established by symptom analysis, upper gastrointestinal endoscopy, 24-h oesophageal pH monitoring, and oesophageal manometry. The oesophago-cardiac reflex was established by oesophageal acid perfusion test (0.1 N HCl and 0.9% NaCl, 120-120 ml/10 min in a blinded manner) combined with transoesophageal Doppler echocardiographic coronary flow measurement in the left anterior descending artery. RESULTS: Gastro-oesophageal reflux disease was established in 45% (23/51) of the patients. Oesophageal acid perfusion decreased the coronary flow velocity in 49% (25/51) of the patients indicating the presence of oesophago-cardiac reflex. Oesophago-cardiac reflex was present more frequently in patients with coronary spasm, than in patients with either epicardial coronary artery disease or microvascular coronary disease (p<0.02). Patients with oesophago-cardiac reflex had higher DeMeester scores, increased number of reflux episodes, fraction time below pH 4, and prolonged acid reflux episodes (p<0.05 for each parameter). CONCLUSIONS: Gastro-oesophageal reflux disease is frequently established in patients with either epicardial or microvascular coronary artery disease or with coronary spasm. The oesophago-cardiac reflex was more frequently observed in patients with coronary spasm. The combination of oesophageal acid perfusion test and transoesophageal Doppler echocardiographic coronary flow measurement seems to be a useful method for the detection of this reflex. Patients with prolonged gastro-oesophageal acid reflux episodes, erosive oesophagitis and coronary spasm may be at higher risk for the development of linked-angina.

Published 9 April 2007 in Int J Cardiol, 118(1): 62-8.
Full-text of this article is available online (may require subscription).

© 2004-2008 Acid Reflux Research Today. All Rights Reserved.