Abstract
The function of the autonomic nervous system was assessed in 23 patients with dysmotility-like functional dyspepsia and 12 healthy volunteers by analysis of 24-hr heart rate variability and a battery of five standardized sympathetic and parasympathetic cardiovascular reflex tests. Measures of heart rate variability were obtained by analysis of ambulatory electrocardiographic recordings using both the time and the frequency domain methods. The values of parameters reflecting vagal activity (HF, rMSSD) were significantly lower in patients with functional dyspepsia. Individual analysis of heart rate variability data identified at least one abnormal parameter of vagal function in seven (30.4%) patients, and in five of these the results of parasympathetic cardiovascular reflex tests were also abnormal. Our results suggest impaired efferent vagal function in a subgroup of patients with functional dyspepsia. This abnormality may play a role in the pathogenesis of the disease in these patients.
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REFERENCES
Malagelada JR: Functional dyspepsia. Insights on mechanisms and management strategies. Gastroenterol Clin North Am 25:103–113, 1996
Thompson DG: Modulation of gastric perception and motility in man. Current concepts and correlation with symptoms. Dig Dis Sci 39(suppl):48S–50S, 1994
Troncon LEA, Thompson DG, Ahluuwalia NK, Barlow J, Heggie L: Relations between upper abdominal symptoms and gastric distension abnormalities in dysmotility-like functional dyspepsia and after vagotomy. Gut 37:17–22, 1995
Greydanus MP, Vassallo M, Camilleri M, Nelson DK, Hanson RB, Thomforde GM: Neurohormonal factors in functional dyspepsia: Insights on pathophysiological mechanisms. Gastroenterology 100:1311–1318, 1991
Holtmann G, Goebell H, Jockenhoevel F, Talley NJ: Altered vagal and intestinal mechanosensory function in chronic unexplained dyspepsia. Gut 42:501–506, 1998
Camilleri M, Fealey RD: Idiopathic autonomic denervation in eight patients presenting with functional gastrointestinal disease: a causal association? Dig Dis Sci 35:609–616, 1990
Bharucha AE, Camilleri M, Low PA, Zinsmeister AR: Autonomic dysfunction in gastrointestinal motility disorders. Gut 34:397–401, 1993
Hausken T, Svebak S, Wilhelmsen I, Haug TT, Olafsen K, Pettersson E, Hveem K, Berstad A: Low vagal tone and antral dysmotility in patients with functional dyspepsia. Psychosom Med 55:12–22, 1993
Ewing DJ, Clarke BF: Diagnosis and management of diabetic autonomic neuropathy. BMJ 285:916–918, 1982
Buysschaert M, Donckier J, Dive A, Ketelslegers JM, Lambert AE: Gastric acid and pancreatic polypeptide responses to sham feeding are impaired in diabetic subjects with autonomic neuropathy. Diabetes 34:1181–1185, 1985
Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology: Heart rate variability. Standards of measurement, physiological interpretation and clinical use. Eur Heart J 17:354–381, 1996
Petretta M, Bonaduce D, Scalfi L, Filippo E, Marciano F, Migaux M-L, Themistoclakis S, Ianniciello A, Contaldo F: Heat rate variability as a measure of autonomic nervous system function in anorexia nervosa. Clin Cardiol 20:219–224, 1997
Tamura K, Tsuji H., Nishiue T, Yajima I, Higashi T, Iwasaka T: Determinants of heart rate variability in chronic hemodialysis patients. Am J Kidney Dis 31:602–606, 1998
Rutter MK, McComb JM, Brady S, Marshall SM: Autonomic neuropathy in asymptomatic subjects with non-insulin dependent diabetes mellitus and microalbuminuria. Clin Auton Res 8:251–257, 1998
Hathaway DK, Cashion AK, Milstead EJ, Winsett R, Cowan PA, Wicks MN, Gaber O: Autonomic dysregulation in patients awaiting kidney transplantation. Am J Kidney Dis 32:221–229, 1998
Ewing DJ, Neilson JMM, Shapiro CM, Stewart JA, Reid W: Twenty four hour heart rate variability: Effects of posture, sleep, and time of day in healthy controls and comparison with bedside tests of autonomic function in diabetic patients. Br Heart J 65:239–244, 1991
Dillon JF, Plevris JN, Nolan J, Ewing DJ, Neilson JMM, Bouchier IAD, Hayes PC: Autonomic function in cirrhosis assessed by cardiovascular reflex tests and 24-hour heart rate variability. Am J Gastroenterol 89:1544–1547, 1994
Talley NJ, Stanghellini V, Heading RC, Koch KL, Malagelada JR, Tytgat GNJ: Functional gastroduodenal disorders. Gut 45(suppIII):II37–II42, 1999
Talley NJ, Weaver AL, Tesmer DL, Zinsmeister AR: Lack of discriminant value of dyspepsia subgroups in patients referred for upper endoscopy. Gastroenterology 105:1378–1386, 1993
Stanghellini V, Tosetti C, Paternicò A, Barbara G, Morselli-Labate AM, Monetti N, Marengo M, Corinaldesi R: Risk indicators of delayed gastricc emptying of solids in patients with functional dyspepsia. Gastroenterology 110:1036–1042, 1996
Tack J, Piessevaux H, Coulie B, Caenepeel P, Janssens J: Role of impaired accomodation to a meal in functional dyspepsia. Gastroenterology 115:1346–1352, 1998
Heitkemper M., Burr RL, Jarrett M, Hertig V, Lustyk MK, Bond EF: Evidence for autonomic nervous system imbalance in women with irritable bowel syndrome. Dig Dis Sci 43:2093–2098, 1998
Talley NJ: Spectrum of chronic dyspepsia in the presence of the irritable bowel syndrome. Scand J Gastroenterol (Suppl) 182:7–10, 1991
Haug TT, Svebak S, Hausken T, Wilhelmsen I, Berstad A, Ursin H: Low vagal activity as mediating mechanism for the relationship between personality factors and gastric symptoms in functional dyspepsia. Psychosom Med 56:181–186, 1994
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Silva Lorena, S.L., de Oliveira Figueiredo, M.J., Souza Almeida, J.R. et al. Autonomic Function in Patients with Functional Dyspepsia Assessed by 24-Hour Heart Rate Variability. Dig Dis Sci 47, 27–31 (2002). https://doi.org/10.1023/A:1013246900041
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DOI: https://doi.org/10.1023/A:1013246900041