Heart Disease and Gluten

[annelb]

As I have coronary artery disease(CAD) I have a special interest concerning gluten and the heart.

Cara has put most of the articles about heart disease in The Gluten File. Only registered and activated users can see links., Click Here To Register...

Here are two more articles that need to be added:
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Echocardiography. 2012 Apr;29(4):471-7. doi: 10.1111/j.1540-8175.2011.01598.x. Epub 2011 Dec 9.
The evaluation of endothelial functions in patients with celiac disease.
Sari C, Bayram NA, Doğan FE, Baştuğ S, Bolat AD, Sarı SÖ, Ersoy O, Bozkurt E.
Source

Department of Cardiology, Atatürk Education and Research Hospital, Ankara, Turkey.
Abstract
AIM:

Celiac disease is characterized by malabsorption resulting from inflammatory injury to the mucosa of the small intestine after the ingestion of wheat gluten or related rye and barley proteins. This study aimed to identify individuals who are at risk of heart failure and increased risk for cardiovascular events by evaluating endothelial function in patients with celiac disease.
MATERIALS AND METHODS:

The study included 36 patients with celiac disease and 35 healthy volunteers. After all routine laboratory examination, left ventricular functions were evaluated with standard two-dimensional, M-mode conventional Doppler methods. Then, flow-mediated dilatation and nitroglycerin-dependent dilatation tests on brachial artery were performed to all patients and controls.
RESULTS:

A total of 36 celiac patients and 35 healthy volunteers were included in the study. The brachial artery diameter at baseline was similar between both groups. Measured brachial artery diameter after hyperemia was 30.19 ± 4.47 mm in celiac patients and 32.35 ± 3.77 mm in the control group. Differences between two groups were statistically significant (P = 0.031). Flow-mediated vasodilatation was lower in celiac patients compared with in controls (10.61 ± 2.64% vs 13.09 ± 2.9%; P = 0.0003). Measured endothelium-independent vasodilatation in the brachial artery before and after nitroglycerin was similar between both groups (P = 0.09 and P = 0.07, respectively).
CONCLUSION:

This research which aimed to evaluate endothelial dysfunction in patients with celiac disease is the first in the literature. As a result of this study, we found endothelial dysfunction at the macrovascular level in celiac patients.

© 2011, Wiley Periodicals, Inc.

PMID:
22150763
[PubMed - indexed for MEDLINE]

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Congenit Heart Dis. 2013 Mar;8(2):E45-8. doi: 10.1111/j.1747-0803.2011.00610.x. Epub 2012 Jan 10.
An unusual cardiomyopathy after physical stress in a child.
Fabi M, Testa G, Gesuete V, Balducci A, Ragni L.
Source

Pediatric Cardiology Unit, S. Orsola-Malpighi Hospital, Bologna, Italy.
Abstract

Takotsubo cardiomyopathy, or broken heart syndrome, is characterized by transient left ventricular dysfunction associated to chest pain, elevation of cardiac enzymes, and electrocardiographic changes, mimicking an acute coronary syndrome, especially in older women after a physical or emotional stress. It is extremely infrequent in children as well as after infective stress. We described a celiac 4-year-old girl, following a gluten-free diet, who developed features of cardiac failure few days after episodes of acute diarrhea with fever. The patient was treated with oral anticongestive therapy and intravenous immunoglobulins, and she had a dramatic and rapid improvement; echocardiographic features normalized in 48 hours.

© 2012 Wiley Periodicals, Inc.

PMID:
22233162
[PubMed - in process]

Episodes of acute diarrhea with fever. Makes me wonder if she had eaten some gluten??
Anne

[annelb]

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The Characterisation and Risk Factors of Ischaemic Heart Disease in Patients With Coeliac Disease

Abstract

Background Studies have shown an increased risk of ischaemic heart disease (IHD) in patients with coeliac disease (CD), despite the patients' lack of traditional IHD risk factors.

Aim To characterise IHD according to CD status.

Methods Data on duodenal or jejunal biopsies were collected in 2006–2008 from all 28 pathology departments in Sweden and were used to define CD (equal to villous atrophy; Marsh stage 3). We used the Swedish cardiac care register SWEDEHEART to identify IHD and to obtain data on clinical status and risk factors at time of first myocardial infarction for this case-only comparison. Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). CD patients were compared with general population reference individuals.

Results We identified 1075 CD patients and 4142 reference individuals with subsequent IHD. CD patients with myocardial infarction had lower body mass index (P < 0.001) and cholesterol values (P < 0.001) and were less likely to be active smokers (OR = 0.74; 95% CI = 0.56–0.98) than reference individuals with myocardial infarction. CD patients had less extensive coronary artery disease at angiography (any stenosis: OR = 0.80; 95% CI = 0.66–0.97; three-vessel disease: OR = 0.73; 95% CI = 0.57–0.94); but there was no difference in the proportions of CD patients with positive biochemical markers of myocardial infarction (CD: 92.2% vs. reference individuals: 91.5%,P = 0.766).

Conclusion Despite evidence of an increased risk of IHD and higher cardiovascular mortality, patients with coeliac disease with IHD have a more favourable cardiac risk profile compared with IHD in reference individuals.

This describes me - CAD with lower body mass, low cholesterol, never smoked. Of course I never had a biopsy while eating gluten but I think whatever goes for CD also goes for GS.
Anne

[annelb]

Aliment Pharmacol Ther. 2013 Jun 3. doi: 10.1111/apt.12360. [Epub ahead of print]
Young adults with coeliac disease may be at increased risk of early atherosclerosis.
De Marchi S, Chiarioni G, Prior M, Arosio E.
Source

Division of Vascular Rehabilitation, Department of Medicine, University of Verona, Verona, Italy.
Abstract
BACKGROUND:

Accelerated progression of atherosclerosis and increased cardiovascular risk have been described in immune-mediated disorders, but few data are available in coeliac disease.
AIM:

To evaluate instrumental and biochemical signs of atherosclerosis risk in 20 adults at first diagnosis of coeliac disease and after 6-8 months of gluten-free diet with mucosal recovery.
METHODS:

We analysed total, high-density lipoprotein (HDL) and low-density lipoprotein (LDL) cholesterol, triglycerides, homocysteine, C-reactive protein, folate and vitamin B12; ultrasound measurement of carotid intima-media thickness (IMT) and endothelium-dependent dilatation were both carried on at diagnosis and after gluten withdrawal. Twenty-two healthy members of the hospital staff served as matched controls for vascular examinations.
RESULTS:

At baseline, mean total and HDL-cholesterol (HDL-C) were both within normal range, while mean LDL-cholesterol concentration was slightly increased; diet was associated with an increment in total and HDL-C (68.2 ± 17.4 vs. 51.4 ± 18.6 mg/dL; P < 0.001) and a significant improvement in total/HDL-C ratio (3.05 ± 0.71 vs. 3.77 ± 0.92; P < 0.02). Mean plasma homocysteine was elevated and not influenced by diet. C-reactive protein significantly decreased with diet (1.073 ± 0.51 vs. 1.92 ± 1.38 mg/dL; P < 0.05). At baseline, in coeliacs, IMT was increased (0.082 ± 0.011 vs. 0.058 ± 0.012 cm; P < 0.005), while endothelium-dependent dilatation was decreased (9.3 ± 1.3 vs. 11.2 ± 1.2%; P < 0.05). Both parameters improved after gluten abstinence.
CONCLUSIONS:

Adults with coeliac disease seem to be at potentially increased risk of early atherosclerosis as suggested by vascular impairment and unfavourable biochemical risk pattern. Chronic inflammation might play a determining role. Gluten abstinence with mucosal normalisation reverts to normal the observed alterations.

© 2013 John Wiley & Sons Ltd.

PMID:
23730933
[PubMed - as supplied by publisher]

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Anne

[jcc]

Filed! Thank you for the nudge :).

[annelb]

New article from Medscape. Here is the conclusion. You can read the complete article. All you have to do is sign up for free access.

Young Adults With Coeliac Disease May Be at Increased Risk of Early Atherosclerosis

Conclusions Adults with coeliac disease seem to be at potentially increased risk of early atherosclerosis as suggested by vascular impairment and unfavourable biochemical risk pattern. Chronic inflammation might play a determining role. Gluten abstinence with mucosal normalisation reverts to normal the observed alterations.

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Anne

[annelb]

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Eur J Prev Cardiol. 2013 Aug 22. [Epub ahead of print]
Follow-up of ischaemic heart disease in patients with coeliac disease.
Emilsson L, Carlsson R, James S, Hambraeus K, Ludvigsson JF.
Source

Vårdcentralen Värmlands Nysäter, Sweden.
Abstract
BACKGROUND:

Patients with coeliac disease and myocardial infarction have a more favourable atherosclerotic risk factor profile than controls with myocardial infarction (MI). Therefore, MI prognosis and treatment may differ according to coeliac status.
DESIGN:

Study of Swedish MI patients with and without coeliac disease (equal to villous atrophy; Marsh histopathology stage 3) based on duodenal or jejunal biopsy data.
METHODS:

We used the Swedish Quality Register (SWEDEHEART) to identify individuals with a record of MI from 2005 to 2008 and to obtain data on medication, coronary interventions, and clinical and laboratory parameters at 6-10 weeks and one year after first MI. One-year mortality and coronary interventions were assessed for 430 coeliac patients and 1988 controls. For other outcome variables, we compared 42 coeliac patients with MI and 201 general population controls with MI. Odds ratios (ORs) were calculated by logistic regression.
RESULTS:

Compared with controls with MI, coeliac individuals with MI had significantly higher one-year all-cause mortality (OR = 1.43; 95% confidence interval (CI) = 1.04-1.95) but less often underwent a percutaneous coronary intervention (OR = 0.77; 95% CI = 0.61-0.96). Coeliac patients were more often prescribed warfarin but less often aspirin and statins. The readmission rate due to cardiac events in coeliac patients was 15.2% vs. 12.6% in controls (p-value = 0.69). Other clinical and laboratory parameters were similar.
CONCLUSION:

Follow-up of MI does not seem to differ between coeliac patients and controls, and is unlikely to explain the excess mortality from cardiovascular disease noted in Swedish patients with CD.
KEYWORDS:

Autoimmunity, coeliac, inflammation, myocardial infarction, risk factors

PMID:
23963400
[PubMed - as supplied by publisher]

[canoe]

Anne,

Thanks for these articles. I really feel that my dad's severe heart disease may have been the result of undiagnosed celiac.

Marilyn

[annelb]

You are welcome. I put them here so I can find them later and so Cara can grab them for TGF.
Anne