Système gastro-intestinal et digestif

Abstrait

Cardiovascular Complications of Gastrointestinal Diseases

Juliana de Castro Solano Martins, Liliana Sampaio Costa Mendes, Andre Rodrigues Duraes

It is known that 10% of all deaths in the United States have gastrointestinal disorders as their underlying cause. As many of these patients present with cardiovascular symptoms apparently related to their primary disorder, the relation between the cardiovascular and gastrointestinal systems has been under intensive investigation. Observational studies and case reports have suggested that gastroesophageal reflux disease can lead to atrial fibrillation and this relation is considered to implicate multiple mechanisms as inflammation, autoimmunity and exacerbated autonomic stimulation. Furthermore, current literature understands that atherosclerosis is a result of both traditional (e.g. diabetes mellitus, dyslipidemia) and non-traditional risk factors, such as chronic inflammation due to chronic infections (e.g. Helicobacter pylori and Hepatitis C virus infections) and chronic inflammatory diseases (e.g. inflammatory bowel disease). Numerous evidences of systolic and diastolic ventricular dysfunction have been reported in cirrhotic patients, being called cirrhotic cardiomyopathy and characterized by blunted contractile responsiveness to stress, diastolic dysfunction and electrophysiological abnormalities in the absence of underlying cardiac disease. Metabolic liver diseases are also related to cardiovascular injury through iron or copper overload in hemochromatosis and Wilson’s disease, respectively. This article intends to review cardiovascular complications due to primary gastrointestinal disorders and their potential physiopathological mechanisms, along with alert physicians of these still neglected gastrointestinal diseases presentations.