Abstract
Background
Heart rate variability (HRV) is a sensitive marker of altered sympathetic–parasympathetic function and is reduced in inflammation, illness, and trauma. The effect of major abdominal surgery on the course of HRV parameters is still an issue requiring further investigation.
Materials and methods
A prospective, observational study including 40 consecutive patients undergoing elective colorectal surgery under “fast-track” perioperative management. Time and frequency domain parameters of HRV were measured 1 day prior to operation and on days 1–5 postoperatively. General and surgical complications as well as the course of leucocytes and C-reactive protein (CRP) were documented and correlated to the HRV measurements.
Results
Time domain parameters of HRV showed a significant decrease compared to the preoperative values on postoperative day 1 and returned to baseline on day 2, demonstrating impaired autonomic regulation in the early postoperative period. No correlation to complications or course of leukocytes or CRP was significant in our study.
Conclusions
Colorectal resections significantly influence the HRV course. The autonomic regulation is reduced in the early postoperative time and all parameters return to baseline until the third day.
Similar content being viewed by others
References
Ushiyama T, Mizushige K, Wakabayashi H, Nakatsu T, Ishimura K, Tsuboi Y, Maeta H, Suzuki Y (2008) Analysis of heart rate variability as an index of noncardiac surgical stress. Hear Vessel 23(1):53–59. doi:10.1007/s00380-007-0997-6
Tsuji H, Larson MG, Venditti FJ Jr, Manders ES, Evans JC, Feldman CL, Levy D (1996) Impact of reduced heart rate variability on risk for cardiac events. The Framingham Heart Study. Circulation 94(11):2850–2855
Sandercock GR, Bromley PD, Brodie DA (2005) The reliability of short-term measurements of heart rate variability. Int J Cardiol 103(3):238–247. doi:10.1016/j.ijcard.2004.09.013
Kleiger RE, Bigger JT, Bosner MS, Chung MK, Cook JR, Rolnitzky LM, Steinman R, Fleiss JL (1991) Stability over time of variables measuring heart rate variability in normal subjects. Am J Cardiol 68(6):626–630
Lakusic N, Slivnjak V, Baborski F, Cerovec D (2009) Heart rate variability after off-pump versus on-pump coronary artery bypass graft surgery. Cardiol Res Pract 2009:295376. doi:10.4061/2009/295376
de Godoy MF, Takakura IT, Correa PR, Machado MN, Miranda RC, Brandi AC (2009) Preoperative nonlinear behavior in heart rate variability predicts morbidity and mortality after coronary artery bypass graft surgery. Med Sci Monit 15(3):CR117–CR122
La Rovere MT (2010) Heart rate and arrhythmic risk: old markers never die. Europace 12(2):155–157. doi:10.1093/europace/eup437
Chattipakorn N, Incharoen T, Kanlop N, Chattipakorn S (2007) Heart rate variability in myocardial infarction and heart failure. Int J Cardiol 120(3):289–296. doi:10.1016/j.ijcard.2006.11.221
Ahmad S, Tejuja A, Newman KD, Zarychanski R, Seely AJ (2009) Clinical review: a review and analysis of heart rate variability and the diagnosis and prognosis of infection. Crit Care 13(6):232. doi:10.1186/cc8132
Seely AJ (2006) Heart rate variability and infection: diagnosis, prognosis, and prediction. J Crit Care 21(3):286–289. doi:10.1016/j.jcrc.2006.06.001
Ahmad S, Ramsay T, Huebsch L, Flanagan S, McDiarmid S, Batkin I, McIntyre L, Sundaresan SR, Maziak DE, Shamji FM, Hebert P, Fergusson D, Tinmouth A, Seely AJ (2009) Continuous multi-parameter heart rate variability analysis heralds onset of sepsis in adults. PLoS One 4(8):e6642. doi:10.1371/journal.pone.0006642
Pontet J, Contreras P, Curbelo A, Medina J, Noveri S, Bentancourt S, Migliaro ER (2003) Heart rate variability as early marker of multiple organ dysfunction syndrome in septic patients. J Crit Care 18(3):156–163
Gogenur I, Rosenberg-Adamsen S, Lie C, Rasmussen V, Rosenberg J (2002) Lack of circadian variation in the activity of the autonomic nervous system after major abdominal operations. Eur J Surg 168(4):242–246. doi:10.1080/11024150260102861
Schwenk W, Gunther N, Wendling P, Schmid M, Probst W, Kipfmuller K, Rumstadt B, Walz MK, Engemann R, Junghans T (2008) "Fast-track" rehabilitation for elective colonic surgery in Germany—prospective observational data from a multi-centre quality assurance programme. Int J Colorectal Dis 23(1):93–99. doi:10.1007/s00384-007-0374-z
Tsilimparis N, Haase O, Wendling P, Kipfmuller K, Schmid M, Engemann R, Schwenk W (2010) [Laparoscopic "fast-track" sigmoidectomy for diverticulitis disease in Germany. Results of a prospective quality assurance program]. Dtsch Med Wochenschr 135 (36):1743-1748. doi:10.1055/s-0030-1263305
Heart rate variability. Standards of measurement, physiological interpretation, and clinical use. Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology (1996). Eur Heart J 17 (3):354-381. doi:10.1161/01.CIR.93.5.1043
Schroeder EB, Whitsel EA, Evans GW, Prineas RJ, Chambless LE, Heiss G (2004) Repeatability of heart rate variability measures. J Electrocardiol 37(3):163–172
Mazzeo AT, La Monaca E, Di Leo R, Vita G, Santamaria LB (2011) Heart rate variability: a diagnostic and prognostic tool in anesthesia and intensive care. Acta Anaesthesiol Scand 55(7):797–811. doi:10.1111/j.1399-6576.2011.02466.x
Gamelin FX, Berthoin S, Bosquet L (2006) Validity of the polar S810 heart rate monitor to measure R–R intervals at rest. Med Sci Sports Exerc 38(5):887–893. doi:10.1249/01.mss.0000218135.79476.9c
Akselrod S, Gordon D, Ubel FA, Shannon DC, Berger AC, Cohen RJ (1981) Power spectrum analysis of heart rate fluctuation: a quantitative probe of beat-to-beat cardiovascular control. Science 213(4504):220–222
Dekker JM, Crow RS, Folsom AR, Hannan PJ, Liao D, Swenne CA, Schouten EG (2000) Low heart rate variability in a 2-minute rhythm strip predicts risk of coronary heart disease and mortality from several causes: the ARIC Study. Atherosclerosis Risk In Communities. Circulation 102(11):1239–1244
Conflicts of interest
None.
Author information
Authors and Affiliations
Corresponding author
Additional information
Authors’ contributions
• Study conception and design: OH, WS
• Acquisition of data: OH, MS, CL
• Analysis and interpretation of data: OH, NT
• Drafting of manuscript: NT, OH
• Critical revision of manuscript: OH, CL. MS, WS, NT
O. Haase and C. Langelotz contributed equally to the manuscript.
Rights and permissions
About this article
Cite this article
Haase, O., Langelotz, C., Scharfenberg, M. et al. Reduction of heart rate variability after colorectal resections. Langenbecks Arch Surg 397, 793–799 (2012). https://doi.org/10.1007/s00423-012-0903-2
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00423-012-0903-2