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Heart rate variability in patients with different manifestations of gastroesophageal reflux disease.
Auton Neurosci. 2004 Nov 30; 116(1-2):39-45.AN

Abstract

BACKGROUND

Autonomic nervous dysfunction has frequently been observed in patients with gastroesophageal reflux diseases (GERD) and impacts the pathogenesis of GERD. However, the characteristics that distinguish between GERD patients with different manifestations remain unknown.

AIM

To investigate the autonomic nervous function in subgroups of GERD patients.

PATIENTS

Of the 164 participants in this study, 57 were healthy controls, 34 had non-erosive reflux disease (NERD), 40 had symptomatic esophagitis (SE), and 33 asymptomatic esophagitis (AE).

METHODS

Resting autonomic activity was assessed by measuring the 5-min heart rate variability (HRV) and HRV indices including time-domain parameters (standard deviation of normal-to-normal intervals [SDNN] and root mean square of successive differences [RMSSD]) and frequency-domain parameters (low-frequency power [LF; 0.04-0.15 Hz], high-frequency power [HF; 0.15-0.4 Hz], and LF/HF power ratio). Mental stress was assessed by use of a self-reported questionnaire (Brief Symptom Rating Scale [BSRS]).

RESULTS

HF power was (ANOVA, p=0.041) but time-domain parameters, LF power, LF/HF power ratio, and BSRS parameters were not significantly different between the four groups. A higher HF power was found in examinees with NERD than in those with SE and AE (LSD methods: both p=0.02). When split into two groups (erosive vs. non-erosive), nearly all measures of autonomic tonus were significantly lower in the erosive than non-erosive group. Age and the presence of endoscopic esophagitis influenced the RMSSD and HF power results in the regression analysis. Mental stress or gender did not correlate with any HRV index.

CONCLUSION

In comparison with NERD subjects, autonomic tonus in patients with endoscopically confirmed esophagitis (even without symptom) is lower. This finding may suggest that the structural state of esophagus but not symptomatology dictates autonomic function status.

Authors+Show Affiliations

Department of Internal Medicine, College of Medicine, National Taiwan University Hospital, 7, Chung-Shan South Road, Taipei, Taiwan.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15556836

Citation

Lee, Yi-Chia, et al. "Heart Rate Variability in Patients With Different Manifestations of Gastroesophageal Reflux Disease." Autonomic Neuroscience : Basic & Clinical, vol. 116, no. 1-2, 2004, pp. 39-45.
Lee YC, Wang HP, Lin LY, et al. Heart rate variability in patients with different manifestations of gastroesophageal reflux disease. Auton Neurosci. 2004;116(1-2):39-45.
Lee, Y. C., Wang, H. P., Lin, L. Y., Lee, B. C., Chiu, H. M., Wu, M. S., Chen, M. F., & Lin, J. T. (2004). Heart rate variability in patients with different manifestations of gastroesophageal reflux disease. Autonomic Neuroscience : Basic & Clinical, 116(1-2), 39-45.
Lee YC, et al. Heart Rate Variability in Patients With Different Manifestations of Gastroesophageal Reflux Disease. Auton Neurosci. 2004 Nov 30;116(1-2):39-45. PubMed PMID: 15556836.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Heart rate variability in patients with different manifestations of gastroesophageal reflux disease. AU - Lee,Yi-Chia, AU - Wang,Hsiu-Po, AU - Lin,Lian-Yu, AU - Lee,Bai-Chin, AU - Chiu,Han-Mo, AU - Wu,Ming-Shiang, AU - Chen,Ming-Fong, AU - Lin,Jaw-Town, PY - 2004/01/13/received PY - 2004/06/05/revised PY - 2004/08/17/accepted PY - 2004/11/24/pubmed PY - 2005/2/16/medline PY - 2004/11/24/entrez SP - 39 EP - 45 JF - Autonomic neuroscience : basic & clinical JO - Auton Neurosci VL - 116 IS - 1-2 N2 - BACKGROUND: Autonomic nervous dysfunction has frequently been observed in patients with gastroesophageal reflux diseases (GERD) and impacts the pathogenesis of GERD. However, the characteristics that distinguish between GERD patients with different manifestations remain unknown. AIM: To investigate the autonomic nervous function in subgroups of GERD patients. PATIENTS: Of the 164 participants in this study, 57 were healthy controls, 34 had non-erosive reflux disease (NERD), 40 had symptomatic esophagitis (SE), and 33 asymptomatic esophagitis (AE). METHODS: Resting autonomic activity was assessed by measuring the 5-min heart rate variability (HRV) and HRV indices including time-domain parameters (standard deviation of normal-to-normal intervals [SDNN] and root mean square of successive differences [RMSSD]) and frequency-domain parameters (low-frequency power [LF; 0.04-0.15 Hz], high-frequency power [HF; 0.15-0.4 Hz], and LF/HF power ratio). Mental stress was assessed by use of a self-reported questionnaire (Brief Symptom Rating Scale [BSRS]). RESULTS: HF power was (ANOVA, p=0.041) but time-domain parameters, LF power, LF/HF power ratio, and BSRS parameters were not significantly different between the four groups. A higher HF power was found in examinees with NERD than in those with SE and AE (LSD methods: both p=0.02). When split into two groups (erosive vs. non-erosive), nearly all measures of autonomic tonus were significantly lower in the erosive than non-erosive group. Age and the presence of endoscopic esophagitis influenced the RMSSD and HF power results in the regression analysis. Mental stress or gender did not correlate with any HRV index. CONCLUSION: In comparison with NERD subjects, autonomic tonus in patients with endoscopically confirmed esophagitis (even without symptom) is lower. This finding may suggest that the structural state of esophagus but not symptomatology dictates autonomic function status. SN - 1566-0702 UR - https://www.unboundmedicine.com/medline/citation/15556836/Heart_rate_variability_in_patients_with_different_manifestations_of_gastroesophageal_reflux_disease_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1566-0702(04)00193-6 DB - PRIME DP - Unbound Medicine ER -