Internal and Emergency Medicine

, Volume 8, Issue 4, pp 333–337 | Cite as

Prevalence of virulent Helicobacter pylori strains in patients affected by idiopathic dysrhythmias

  • Francesco Franceschi
  • Donatella Brisinda
  • Francesco Buccelletti
  • Maria Pia Ruggieri
  • Antonio Gasbarrini
  • Annarita Sorbo
  • Davide Marsiliani
  • Angela Venuti
  • Peter Fenici
  • Giovanni Gasbarrini
  • Nicolò Gentiloni Silveri
  • Riccardo Fenici
IM - ORIGINAL

Abstract

Helicobacter pylori virulent strains have been shown to affect cardiovascular diseases through molecular mimicry mechanisms. Silent autoimmune myocarditis has been hypothesized to be the cause of idiopathic dysrhythmias (IA). The aim of this study is to assess the prevalence of virulent H. pylori strains in patients affected by IA. In this study,54 patients (40 men, mean age 44 ± 17 years) affected by IA and 50 healthy subjects (34 men, mean age 45 ± 9) were evaluated. IA, defined as dysrhythmias with no evidence of other cardiac pathology, were either supraventricular (SVA, 23 patients; mean age 45 ± 15 years) or ventricular (VA, 31 patients; mean age 42 ± 18 years). H. pylori infection and gastrointestinal (GI) symptoms were evaluated. H. pylori strains expressing the cytotoxin-associated gene A (cagA) and the vacuolating-cytotoxin A (vacA) were also assessed through western blot. The prevalence of H. pylori is similar in IA patients and in controls (42 vs. 44%; p > 0.05); H. pylori infection is observed in 48 and 39% of the patients are affected by SVA and VA, respectively. The prevalence of CagA-positive strains is increased in IA patients compared to controls (65 vs. 42%; p < 0.01); similarly, the prevalence of VacA-positive strains is also increased in IA patients (74 vs. 46%; p < 0.006). Excluding belching, infected patients did not show any difference in GI symptoms, when compared to non-infected subjects. From this study it is concluded that there is an epidemiological link between CagA and VacA-positive H. pylori strains in IA patients.

Keywords

Helicobacter pylori Dysrhythmias Cytotoxins Autoimmunity 

Notes

Acknowledgments

This study was partly supported by a grant from Associazione Ricerca in Medicina, Bologna, Italy.

Conflict of interest

None.

References

  1. 1.
    Frustaci A, Caldarulo M, Buffon A, Bellocci F, Fenici R, Melina D (1991) Cardiac biopsy in patients with “primary” atrial fibrillation. Chest 100:303–306PubMedCrossRefGoogle Scholar
  2. 2.
    Kumagai K, Akimitsu S, Kawahira K, Kawanami F, Yamanouchi Y, Hiroki T et al (1991) Electrophysiological properties in chronic lone atrial fibrillation. Circulation 84:1662–1668PubMedCrossRefGoogle Scholar
  3. 3.
    Deal BJ, Miller SM, Scagliotti D, Prechel D, Gallestegni JL, Hariman RJ (1986) Ventricular tachycardia in a young population without overt heart disease. Circulation 73:1111–1118PubMedCrossRefGoogle Scholar
  4. 4.
    Frustaci A, Bellocci F, Olsen ECJ (1994) Results of biventricular endomyocardial biopsy in survivors of cardiac arrest with apparently normal hearts. Am J Cardiol 74:890–895PubMedCrossRefGoogle Scholar
  5. 5.
    Viskin S, Belhassen B (1990) Idiopathic ventricular fibrillation. Am Heart J 120:661–671PubMedCrossRefGoogle Scholar
  6. 6.
    Topaz O, Perin E, Cox M, Mallon SM, Castellanos A, Myerburg RJ (1989) Young adult survivors of sudden cardiac arrest: analysis of invasive evaluation of 22 subjects. Am Heart J 118:281–287PubMedCrossRefGoogle Scholar
  7. 7.
    Schoenfeldt MH (1988) The cardiac arrest survivor: lessons from the electrophysiology laboratory. JACC 12:978–981Google Scholar
  8. 8.
    Lemery R, Brugada P, Della Bella P, Dugernier T, Wellens HJJ (1989) Ventricular fibrillation in six adults without overt heart disease. JACC 13:911–916PubMedCrossRefGoogle Scholar
  9. 9.
    Mac Arthur CGC, Tarin D, Goodwin JF, Hallidie-Smith KA (1984) The relationship of myocarditis to dilated cardiomyopathy. Eur Heart J 5:1023–1035Google Scholar
  10. 10.
    Kawai C, Matsumori A, Fujiwara H (1987) Myocarditis and dilated cardiomyopathy. Ann Rev Med 38:221–239PubMedCrossRefGoogle Scholar
  11. 11.
    De Koster E (1993) Microbiological aspects of Helicobacter pylori. Eur J Gastroenterol. Hepat 5:S33–S35Google Scholar
  12. 12.
    Gasbarrini G, Pretolani S, Bonvicini F, Gatto MRA, Tonelli E, Megraud F et al (1995) A population based study of Helicobacter pylori infection in a European country: the San Marino study.Relations with gastrointestinal diseases. Gut 36:838–844PubMedCrossRefGoogle Scholar
  13. 13.
    Calam J (1994) Helicobacter pylori. Eur J Clin Invest 24:501–510PubMedCrossRefGoogle Scholar
  14. 14.
    Walker MM, Pretolani S, Gasbarrini G (1996) Gastric carcinoma and gastric lymphoma. Curr Opin Gastroenterol. 12(suppl. 1):33–36CrossRefGoogle Scholar
  15. 15.
    Moran AP (1996) Pathogenic properties of Helicobacter pylori. Scand J Gastroenterol. 31(suppl):3–10Google Scholar
  16. 16.
    Crabtree JE (1996) Immune and inflammatory response to Helicobacter pylori infection. Scand J Gastroenterol. 31(suppl):3–10CrossRefGoogle Scholar
  17. 17.
    Figura N, Tabaqchali S (1996) Bacterial pathogenic factors. Curr Opin Gastroenterol. 12(suppl. 1):33–36Google Scholar
  18. 18.
    Gasbarrini A, Franceschi F, Gasbarrini G, Pola P (1997) Extraintestinal pathology associated with Helicobacter infection. Eur J Gastroenterol Hepatol 9:231–233PubMedCrossRefGoogle Scholar
  19. 19.
    Gasbarrini A, Serricchio M, Tondi P, Gasbarrini G, Pola P (1996) Association of Helicobacter pylori infection with Raynaud phenomenon. Lancet 348:966–967PubMedCrossRefGoogle Scholar
  20. 20.
    Mendall MA, Goggin PM, Molineaux N, Levy J, Toosy T, Strachan D et al (1994) Relation of Helicobacter pylori infection and coronary heart disease. Br Heart J 71:437–439PubMedCrossRefGoogle Scholar
  21. 21.
    Reinauer S, Megahed M, Goerz G, Ruzicka T, Borchard F, Susanto F et al (1995) Schonlein-Henoch purpura associated with gastric Helicobacter pylori infection. J Am Acad Dermatol 33:876–879PubMedCrossRefGoogle Scholar
  22. 22.
    Figura N, Giordano N, Burroni D, Macchia G, Vindigni G, Gennari C et al (1994) Sjogren’s syndrome and Helicobacter pylori infection. Eur J Gastroenterol Hepatol 6:321–322Google Scholar
  23. 23.
    Pellicano R, Franceschi F, Saracco G, Fagoonee S, Roccarina D, Gasbarrini A (2009) Helicobacters and extragastric diseases. Helicobacter 14(Suppl 1):58–68PubMedCrossRefGoogle Scholar
  24. 24.
    Franceschi F, Sepulveda AR, Gasbarrini A, Pola P, Silveri NG, Gasbarrini G, Graham DY, Genta RM (2002) Cross-reactivity of anti-CagA antibodies with vascular wall antigens: possible pathogenic link between Helicobacter pylori infection and atherosclerosis. Circulation 106:430–434PubMedCrossRefGoogle Scholar
  25. 25.
    Bunch TJ, Day JD, Anderson JL, Horne BD, Muhlestein JB, Crandall BG, Weiss JP, Lappe DL, Asirvatham SJ (2008) Frequency of Helicobacter pylori seropositivity and C-reactive protein increase in atrial fibrillation in patients undergoing coronary angiography. Am J Cardiol 101:848–851PubMedCrossRefGoogle Scholar
  26. 26.
    Andrew P, Montenero AS (2007) Is there a link between atrial fibrillation and certain bacterial infections? J Cardiovasc Med (Hagerstown) 8:990–996CrossRefGoogle Scholar
  27. 27.
    Badran HM, Mahfouz ME (2007) Cytotoxin-associated gene-A bearing strains of Helicobacter pylori and a trial fibrillation due to ischemic origin: is there a link? Eur J Cardiovasc Prev Rehabil 14:518–520PubMedCrossRefGoogle Scholar
  28. 28.
    Montenero AS, Mollichelli N, Zumbo F, Antonelli A, Dolci A, Barberis M, Sirolla C, Staine T, Fiocca L, Bruno N, O’Connor S (2005) Helicobacter pylori and a trial fibrillation: a possible pathogenic link. Heart 91:960–961PubMedCrossRefGoogle Scholar
  29. 29.
    Lown B, Calvert AF, Armington R, Ryan M (1975) Monitoring for serious arrhythmias and high risk of sudden death. Circulation 52(6 Suppl):III189–III198PubMedGoogle Scholar
  30. 30.
    Negrini R, Savio A, Poiesi C, Appelmelk BJ, Buffoli F, Paterlini A et al (1996) Antigenic mimicry between Helicobacter pylori and gastric mucosa in the pathogenesis of body atrophic gastritis. Gastroenterology 111:655–665PubMedCrossRefGoogle Scholar
  31. 31.
    Malfertheiner P, Megraud F, O’Morain C, Bazzoli F, El-Omar E, Graham D, Hunt R, Rokkas T, Vakil N, Kuipers EJ (2007) Current concepts in the management of Helicobacter pylori infection: the Maastricht III Consensus Report. Gut 56:772–781PubMedCrossRefGoogle Scholar
  32. 32.
    Herbella FA, Patti MG (2010) Gastroesophageal reflux disease: From pathophysiology to treatment. World J Gastroenterol 16:3745–3749PubMedCrossRefGoogle Scholar
  33. 33.
    Good E, Wells D, Cronin P, Morady F, Oral H (2008) Images in cardiovascular medicine.Massive hiatal hernia and thoracic stomach illustrated by barium swallow during left atrial catheter ablation for a trial fibrillation. Circulation 118:2011–2012PubMedCrossRefGoogle Scholar

Copyright information

© SIMI 2011

Authors and Affiliations

  • Francesco Franceschi
    • 1
  • Donatella Brisinda
    • 1
  • Francesco Buccelletti
    • 1
  • Maria Pia Ruggieri
    • 2
  • Antonio Gasbarrini
    • 1
  • Annarita Sorbo
    • 1
  • Davide Marsiliani
    • 1
  • Angela Venuti
    • 1
  • Peter Fenici
    • 2
  • Giovanni Gasbarrini
    • 1
  • Nicolò Gentiloni Silveri
    • 1
  • Riccardo Fenici
    • 2
  1. 1.Internal Medicine DepartmentCatholic UniversityRomeItaly
  2. 2.Centro di Biomagnetismo-Fisiologia ClinicaUniversità Cattolica del S. CuoreRomeItaly

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