Published online Jun 14, 2015. doi: 10.3748/wjg.v21.i22.6982
Peer-review started: November 27, 2014
First decision: January 8, 2015
Revised: January 26, 2015
Accepted: March 27, 2015
Article in press: March 27, 2015
Published online: June 14, 2015
Processing time: 203 Days and 9.4 Hours
AIM: To investigate autonomic nervous function in patients with a diagnosis of gastroesophageal reflux disease (GERD).
METHODS: The investigation was performed on 29 patients (14 men), aged 18-80 years (51.14 ± 18.34), who were referred to our Neurocardiology Laboratory at the Clinical and Hospital Center “Bezanijska Kosa” with a diagnosis of GERD. One hundred sixteen healthy volunteers matched in age and sex with the examinees served as the control group. The study protocol included the evaluation of autonomic function and hemodynamic status, short-term heart rate variability (HRV) analysis, 24 h ambulatory ECG monitoring with long-term HRV analysis and 24 h ambulatory blood pressure monitoring.
RESULTS: Pathologic results of cardiovascular reflex test were more common among patients with reflux compared to the control group. Severe autonomic dysfunction was detected in 44.4% of patients and in 7.9% of controls (P < 0.001). Parameters of short-term analysis of RR variability, which are the indicators of vagal activity, had lower values in patients with GERD than in the control group. Long-term HRV analysis of time-domain parameters indicated lower values in patients with reflux disease when compared to the control group. Power spectral analysis of long-term HRV revealed lower low- and high-frequency values. Detailed 24 h ambulatory blood pressure analysis showed significantly higher values of systolic blood pressure and pulse pressure in the reflux group than in the control group.
CONCLUSION: Patients with GERD have distortion of sympathetic and parasympathetic components of the autonomic nervous system, but impaired parasympathetic function appears more congruent to GERD.
Core tip: Autonomic nervous function was assessed in patients with gastroesophageal reflux disease (GERD) for the purpose of treating patients according to their presenting autonomic pattern. The results demonstrate that autonomic dysfunction is more frequently detected in patients than in controls. Parameters of short-term and long-term analysis of heart rate variability had lower value while blood pressure was higher in patients than in the controls. In conclusion, patients with GERD have distortion of both components of autonomic nervous system, but the impairment of parasympathetic function is more congruent to GERD.