Predictor properties of indicators of undifferentiated connective tissue dysplasia in children with gastroesophageal reflux for prediction of the development of heart rhythm and conduction disorders

Abstract

The aim: to improve the early diagnosis of cardiac arrhythmia and conduction disorders in children with gastroesophageal reflux by studying the predictor properties of indicators of undifferentiated connective tissue dysplasia in this category of patients. Materials and methods. We examined 56 children aged 8 to 18 years, with an average age of 14.93±2.62 years, of which 28 children with gastroesophageal reflux in combination with cardiac arrhythmias and conduction disorders were divided into group I, and 28 children with only gastroesophageal reflux without heart rhythm and conduction disturbances – into group II (control). All examined patients underwent clinical and instrumental studies (electrocardiography, 24-hour ECG Holter monitoring, esophagogastroduodenoscopy and PH-metry) and an assessment of the phenotypic signs of undifferentiated connective tissue dysplasia according to the criteria of T. Milkovskaya-Dimitrova and A. Karkashov. Results. When analyzing the predictor properties of indicators of undifferentiated connective tissue dysplasia for predicting the development of cardiac arrhythmias and conduction disorders in children with gastroesophageal reflux, it was found that scoliotic posture had very high predictor properties (I=5.99), а high growth (I=1.94) and a short upper lip (I=1.17) – high, dysplastic tooth growth (I=0 .6) – moderate, and an abnormal shape of the auricles – low ones (I=0.27). Other indicators of undifferentiated connective tissue dysplasia did not have predictive properties at all: joint hypermobility (I=0.22), total number of signs of undifferentiated connective tissue dysplasia (I=0.11), asthenic type of constitution (I=0.11), flat feet (I=0.08), refractive errors (I=0.05), deviated septum of nose (I=0.03), dilated bridge of the nose (I=0.01), short neck (I=0.01). The mean value of the prognostic significance of indicators of undifferentiated connective tissue dysplasia was high (І̅=1,99). Conclusions. It was found that the mean value of the prognostic significance of indicators of undifferentiated connective tissue dysplasia was high (І̅=1,99). It was determined that arrhythmias and cardiac conduction disturbances in children with gastroesophageal reflux are associated with the presence of a scoliotic posture (І=5,99), high growth (І=1,94), dysplastic growth of teeth (І=0,6); in the absence of a short upper lip (І=1,17) and an abnormal shape of the auricles (І=0,27)