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Circadian change of cardiac autonomic function in correlation with intra-esophageal pH.
J Gastroenterol Hepatol. 2006 Aug; 21(8):1302-8.JG

Abstract

BACKGROUND AND AIM

Although autonomic alterations are observed in patients with gastroesophageal reflux disease (GERD), the influence of visceral receptor responses on the dynamics of autonomic function remains unknown. The aim of this study was to investigate the autonomic functional changes in association with intra-esophageal pH under ambulation.

METHODS

Thirty patients referred for 48 h ambulatory pH monitoring underwent simultaneous 24 h cardiac monitoring for heart rate variability (HRV). We used linear mixed-effects models to estimate the relationship between esophageal acid exposure and power spectral analysis of HRV, including low-frequency power (0.04 < LF < 0.15 Hz), high-frequency power (0.15 < or = HF < 0.4 Hz), and LF/HF power ratio.

RESULTS

Over the 24-h period, patients with pathological reflux had lower average LF and HF powers than patients with functional heartburn, but the LF/HF power ratios were similar for the two patient groups. As we stratified the data according to waking and sleeping times, a significantly higher HF power but lower LF/HF power ratio was found during sleeping time regardless of diagnosis. In the regression analysis, esophageal pH was positively associated with change (not basal tone) of both LF and HF powers during waking, but only with change of HF power during sleeping time. The significant associations between pH values and changes in HRV decreased gradually with time. The LF/HF power ratio did not alter significantly with pH.

CONCLUSION

Esophageal acid exposure is generally associated with decreases in autonomic tone. A predominant parasympathetic fluctuation during sleeping and a superimposed sympathetic interaction during waking dictate diurnal characteristics of autonomic regulation.

Authors+Show Affiliations

Department of Internal Medicine, College of Medicine, National Taiwan University, 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

16872314

Citation

Lee, Yi-Chia, et al. "Circadian Change of Cardiac Autonomic Function in Correlation With Intra-esophageal PH." Journal of Gastroenterology and Hepatology, vol. 21, no. 8, 2006, pp. 1302-8.
Lee YC, Wang HP, Lin LY, et al. Circadian change of cardiac autonomic function in correlation with intra-esophageal pH. J Gastroenterol Hepatol. 2006;21(8):1302-8.
Lee, Y. C., Wang, H. P., Lin, L. Y., Chuang, K. J., Chiu, H. M., Wu, M. S., Chen, M. F., & Lin, J. T. (2006). Circadian change of cardiac autonomic function in correlation with intra-esophageal pH. Journal of Gastroenterology and Hepatology, 21(8), 1302-8.
Lee YC, et al. Circadian Change of Cardiac Autonomic Function in Correlation With Intra-esophageal PH. J Gastroenterol Hepatol. 2006;21(8):1302-8. PubMed PMID: 16872314.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Circadian change of cardiac autonomic function in correlation with intra-esophageal pH. AU - Lee,Yi-Chia, AU - Wang,Hsiu-Po, AU - Lin,Lian-Yu, AU - Chuang,Kai-Jen, AU - Chiu,Han-Mo, AU - Wu,Ming-Shiang, AU - Chen,Ming-Fong, AU - Lin,Jaw-Town, PY - 2006/7/29/pubmed PY - 2006/12/9/medline PY - 2006/7/29/entrez SP - 1302 EP - 8 JF - Journal of gastroenterology and hepatology JO - J. Gastroenterol. Hepatol. VL - 21 IS - 8 N2 - BACKGROUND AND AIM: Although autonomic alterations are observed in patients with gastroesophageal reflux disease (GERD), the influence of visceral receptor responses on the dynamics of autonomic function remains unknown. The aim of this study was to investigate the autonomic functional changes in association with intra-esophageal pH under ambulation. METHODS: Thirty patients referred for 48 h ambulatory pH monitoring underwent simultaneous 24 h cardiac monitoring for heart rate variability (HRV). We used linear mixed-effects models to estimate the relationship between esophageal acid exposure and power spectral analysis of HRV, including low-frequency power (0.04 < LF < 0.15 Hz), high-frequency power (0.15 < or = HF < 0.4 Hz), and LF/HF power ratio. RESULTS: Over the 24-h period, patients with pathological reflux had lower average LF and HF powers than patients with functional heartburn, but the LF/HF power ratios were similar for the two patient groups. As we stratified the data according to waking and sleeping times, a significantly higher HF power but lower LF/HF power ratio was found during sleeping time regardless of diagnosis. In the regression analysis, esophageal pH was positively associated with change (not basal tone) of both LF and HF powers during waking, but only with change of HF power during sleeping time. The significant associations between pH values and changes in HRV decreased gradually with time. The LF/HF power ratio did not alter significantly with pH. CONCLUSION: Esophageal acid exposure is generally associated with decreases in autonomic tone. A predominant parasympathetic fluctuation during sleeping and a superimposed sympathetic interaction during waking dictate diurnal characteristics of autonomic regulation. SN - 0815-9319 UR - https://www.unboundmedicine.com/medline/citation/16872314/Circadian_change_of_cardiac_autonomic_function_in_correlation_with_intra_esophageal_pH_ L2 - https://doi.org/10.1111/j.1440-1746.2006.04147.x DB - PRIME DP - Unbound Medicine ER -