Circadian change of cardiac autonomic function in correlation with intra-esophageal pH

Yi Chia Lee, Hsiu Po Wang, Lian Yu Lin, Kai Jen Chuang, Han Mo Chiu, Ming Shiang Wu, Ming Fong Chen, Jaw Town Lin

Research output: Contribution to journalArticle

7 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)1302-1308
Number of pages7
JournalJournal of Gastroenterology and Hepatology (Australia)
Volume21
Issue number8
DOIs
Publication statusPublished - 2006
Externally publishedYes

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Heart Rate
Ambulatory Monitoring
Heartburn
Acids
Gastroesophageal Reflux
Walking
Regression Analysis

Keywords

  • Autonomic nervous system
  • Bravo pH monitoring system
  • Gastroesophageal reflux disease
  • Heart rate variability

ASJC Scopus subject areas

  • Gastroenterology
  • Hepatology

Cite this

Circadian change of cardiac autonomic function in correlation with intra-esophageal pH. / Lee, Yi Chia; Wang, Hsiu Po; Lin, Lian Yu; Chuang, Kai Jen; Chiu, Han Mo; Wu, Ming Shiang; Chen, Ming Fong; Lin, Jaw Town.

In: Journal of Gastroenterology and Hepatology (Australia), Vol. 21, No. 8, 2006, p. 1302-1308.

Research output: Contribution to journalArticle

Lee, Yi Chia ; Wang, Hsiu Po ; Lin, Lian Yu ; Chuang, Kai Jen ; Chiu, Han Mo ; Wu, Ming Shiang ; Chen, Ming Fong ; Lin, Jaw Town. / Circadian change of cardiac autonomic function in correlation with intra-esophageal pH. In: Journal of Gastroenterology and Hepatology (Australia). 2006 ; Vol. 21, No. 8. pp. 1302-1308.
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