The Acute Effect of Biological Agents used in Inflammatory Bowel Disease on ECG Parameters

Aims Ulcerative colitis and Crohn’s disease are chronic inflammatory bowel diseases.The effect of inflammation on atrial and ventricular conduction defects is known,however,different results have been obtained in many studies on the effectiveness of anti TNFs and biological agents on cardiac conduction. We aimed to evaluate the effects of biological agents on atrial and ventricular conduction in IBD through ECG parameters.

Methods A total of 99 IBDs with UC(38 patients) and Crohn’s disease(61 patients) were included in this prospective study.Patients followed under infliximab or vedolizumab therapy for the treatment of IBD were included. Twelve-lead ECGs were obtained for all participants and ECG parameters QT,QTc,Tpe,Tpe/QT,Tpe/QTc,QRS,Pmax,Pmin,PWD were evaluated before and after the infusion for all patients.

Results

Tab. 1

N	Mean	Std.Dev.	p
QT	Before infusion		<,001
n	99
Mean	375,2525
Std.Dev	27,70115
	After infusion
n	99
Mean	411,3434
Std.Dev	28,13893
QTd	Before infusion		,027
n	99
Mean	22,5657
Std.Dev	13,36471
	After infusion
n	99
Mean	27,4949
Std.Dev	18,04946
Tpe/QT	Before infusion		<,001
n	99
Mean	,2395
Std.Dev	,02769
	After infusion
n	99
Mean	,2654
Std.Dev	,03233
Tpe/QTc	Before infusion		<,001
n	99
Mean	,2112
Std.Dev	,02526
	After infusion
n	99
Mean	,2468
Std.Dev	,02941

A total of 99 IBDs from 61 men (61.6 %) were included in our study. Mean age of the patients was 46.48 +/- 23.8 years. The mean age of the disease was 17.5+/-13.17 years. 90.6 % of the patients were using infliximab and 9.4 % vedolizumab. The mean duration of biological agent use was 44.77 +/- 34.75 months. 12.1 % of the patients had a history of using a different biological agent before. When the laboratory findings of the patients were examined, calcium was 9.41 +/- 0.4mg/dl, and the CRP level was 8.23 +/- 13.6 mg/dl. It was found that the QT, QTc, Tpe, Tpe/QT, Tpe/QTc/QTd values of the patients, evaluated before and after the infusion, were statistically significantly prolonged after the infusion ([Table 1]). When this difference in ECG parameters was examined in terms of gender, age, IBD type and the effect of immunosuppressives used, it was not found statistically significant.

Conclusions It was found that QT,QTc,Tpe,Tpe/QT,Tpe/QTc/QTd parameters,which are considered as ventricular repolyirization indicators,were prolonged after the application of antiTNF and vedolizumab,however,there was no statistically significant difference in Pmax,Pmin,PWD,which are accepted as atrial conduction parameters.

Citation: Çavuş B, Çiftcibaşı Örmeci A, Kaya D etal. eP261 THE ACUTE EFFECT OF BIOLOGICAL AGENTS USED IN INFLAMMATORY BOWEL DISEASE ON ECG PARAMETERS. Endoscopy 2021; 53: S183.

Publication History

Article published online:
19 March 2021