Summary
The use of H2-blockers in the treatment of patients with peptic ulcer has become popular. However, this treatment has adverse cardiovascular effects. The aim of this study was to investigate proarrhythmic rhythm and autonomic nervous activity by analyzing heart rate variability in patients treated with omeprazole, ranitidine, and plaunotol. Nineteen patients (mean age 67.5 ± 2.7 years) with active gastric ulcer were treated with omeprazole (20 mg/day) for 8 weeks, then ranitidine (300 mg/day) for the next 4 months, and finally plaunotol (240 mg/day). At each stage of the treatment, Holter electrocardiography was performed, and heart rate variability and arrhythmias analyzed. Heart rate variability yielded power in the low- (0.04–0.15 Hz) and high-frequency components (0.15–0.4Hz). Although both ranitidine and omeprazole induced little change in cardiac rhythm, the high-frequency power was higher (10.3 ± 0.8 vs 8.6 ± 0.6 ms,P < 0.05) and the ratio of low-to-high frequency power was lower (1.41 ± 0.10 vs 1.59 ± 0.09,P < 0.05) during ranitidine than during plaunotol treatment. Cosinor analysis of heart rate variability revealed a decreased amplitude of lowfrequency power during omeprazole compared with during ranitidine and plaunotol treatment. Ranitidine modulated high-frequency power which may be related to the adverse cardiovascular effects of H2-blocker.
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References
Ishizaki M, Yamada Y, Kido T, Yamaya H, Nogawa K, Matsui S, Murakami E (1987) First-degree atrioventricular block induced by oral cimetidine. Lancet 1:225–226
Khera DC, Smith SL, Slabic SF (1988) Ranitidine-induced bradycardia. Am J Gastroenterol 83:332–333
Allegri G, Pellegrini K, Dobrilla G (1988) First-degree atrioventricular block in a young duodenal ulcer patient treated with a standard oral dose of ranitidine. Agents Actions 244:237–242
Balestrazzi P, Gregori G, Bernasconi S, Giovannelli G (1985) Bradycardia and neurologic disorders associated with ranitidine in a child. Am J Dis Child 139: 442
Engel TR, Luck JC (1979) Histamine 2 receptor antagonism by cimetidine and sinus-node function. N Engl J Med 301:591–592
Gould L, Reddy CV, Singh BK (1981) Electrophysiologic properties of cimetidine in man. PACE 4:3–7
Halabi A, Kirch W (1992) Cardiovascular effects of omeprazole and famotidine. Scand J Gastroenterol 27:753–756
Larsson H, Carlsson E, Junggren U, Olbe L, Sjostrand SE, Skanberg I, Sundell G (1983) Inhibition of gastric acid secretion by omeprazole in the dog and rat. Gastroenterology 85:900–907
Thiefin G, Tache Y, Leung FW, Guth PH (1989) Central nervous system action of thyrotropin-releasing hormone to increase gastric mucosal blood flow in the rat. Gastroenterology 97:405–411
Cho CH, Chen BW, Hui WM, Lam SK, Ogle CW (1992) The role of the vagus nerve in the protective action of acid inhibitors on ethanol-induced gastric mucosal damage in rats. J Gastroenterol Hepatol 7:178–183
Pagani M, Lombardi F, Guzzetti S, Rimoldi O, Furlan R, Pizzinelli P, Sandrone G, Malfatto G, Dell'Orto S, Piccaluga E (1986) Power spectral analysis of heart rate and arterial pressure variabilities as a marker of sympatho-vagal interaction in man and conscious dog. Circ Res 59:178–193
Öri Z, Monir G, Weiss J, Sayhouni X, Singer DH (1992) Heart rate variability. Frequency domain analysis. Cardiol Clin 10:499–537
Malpas SC, Purdie GL (1990) Circadian variation of heart rate variability. Cardiovasc Res 24:210–213
Malpas SC, Maling TJ (1990) Heart-rate variability and cardiac autonomic function in diabetes. Diabetes 39:1177–1181
Ewing DJ, Borsey DQ, Travis P, Bellavere F, Neilson JM, Clarke BF (1983) Abnormalities of ambulatory 24-hour heart rate in diabetes mellitus. Diabetes 32:101–105
Nelson W, Tong YL, Lee JK (1979) Methods for cosinorrhythmometry. Chronobiologia 6:305–323
Fandriks L, Jonson C (1990) Effects of acute administration of omeprazole or ranitidine on basal and vagally stimulated gastric acid secretion and alkalinization of the duodenum in anaesthetized cats. Acta Physiol Scand 138:181–186
Håkanson R, Axelson J, Tielemans Y, Johansson AG, Willems G, Sundler F (1992) Unilateral vagal denervation suppresses omeprazole-induced trophic effects on the denervated side of the rat stomach. Scand J Gastroenterol 27:65–70
Bertaccini G, Coruzzi G (1992) Untoward reactions to gastric antisecretory drugs. Ital J Gastroenterol 24:470–471
Hinrichsen H, Halabi A, Kirch W (1992) Haemodynamic effects of H2-receptor antagonists. Eur J Clin Invest 22:9–18
Bertaccini G, Coruzzi G (1982) Cholinergic-like effects of the new histamine H2-receptor antagonist ranitidine. Agents Actions 12:168–171
Okuma Y, Yokotani K, Murakami Y, Osumi Y (1997) Brain histamine mediates the bombesin-induced central activation of sympatho-adrenomedullary outflow. Life Sci 61:2521–2528
Hinrichsen H, Halabi A, Kirch W (1990) Hemodynamic effects of different H2-receptor antagonists. Clin Pharmacol Ther 48:302–308
Wolff AA, Levi R (1986) Histamine and cardiac arrhythmias. Circ Res 58:1–16
Arita M, Saikawa T (1982) Antigen-induced acceleration of automaticity in electrically depolarized ventricular myocardium of sensitized guinea pigs. Can J Physiol Pharmacol 60:1724–1730
Levi R, Zavecz JH (1979) Acceleration of idioventricular rhythms by histamine in guinea pig heart: mediation by H2 receptors. Circ Res 44:847–855
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Ooie, T., Saikawa, T., Hara, M. et al. H2-Blocker modulates heart rate variability. Heart Vessels 14, 137–142 (1999). https://doi.org/10.1007/BF02482297
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DOI: https://doi.org/10.1007/BF02482297