Circadian change of cardiac autonomic function in correlation with intra-esophageal pH
Journal
Journal of Gastroenterology and Hepatology (Australia)
Journal Volume
21
Journal Issue
8
Pages
1302-1308
Date Issued
2006
Author(s)
Chuang K.-J.
Lin J.-T.
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. ? 2006 Journal of Gastroenterology and Hepatology Foundation and Blackwell Publishing Asia Pty Ltd.
SDGs
Other Subjects
acidity; adult; aged; article; autonomic nervous system; cholinergic system; circadian rhythm; clinical article; controlled study; correlation analysis; esophagus; exposure; female; gastroesophageal reflux; heart function; heart rate variability; heartburn; human; male; monitoring; pathology; pH measurement; priority journal; regression analysis; sleep; spectroscopy; wakefulness
Publisher
Blackwell Publishing
Type
journal article