Heart Rate Variability in Patients with Gastroesophageal Reflux Disease - A Prospective Study

Background Sympatho-vagal balance seems to be disturbed in patients with gastro-oesophageal reflux disease (GERD). We aimed to assess time (SSDN) and frequency domain (LF/HF ratio) parameters of heart rate variability (HRV) in patients with GERD. Material and methods Patients were prospectively included by a joint team consisting of gastroenterologist and cardiologist. GERD diagnosis was clinically assessed by gastroenterologist. In addition, all patients underwent upper gastrointestinal endoscopy and 24-hour ECG Holter monitoring. All patients were in stable sinus rhythm, with no history of arrhythmias. Results Sixty patients were included in 2 groups: 25 patients with GERD (study group: 52% men, 64 +/- 10 years, BMI 29 +/- 5 kg/m(2)) and 35 patients without GERD (control group: 39% men, 59 +/- 11 years, BMI 29 +/- 5 kg/m(2)); all p>0.05. None statistically significance differences between cardiovascular risk factors of the 2 groups were obtained. Esophagitis was diagnosed in 56% of patients with GERD and 14% of patients without GERD (p=0.001). Hiatal hernia was present in 16% of patients with GERD and 20% of patients without GERD (p=0.94). Heart rate variability in time (SSDN value of 88 +/- 53ms versus 146 +/- 33ms; p=0.001) and not in frequency (LF/HF ratio value of 0.76 +/- 0.24 versus 0.72 +/- 0.17; p=0.749) domain parameters were statistically significant different between patients with GERD versus without GERD. Conclusions In this small prospective study, lower value of SDNN in patients with GERD suggests lower HRV and implicitly an increased risk for arrhythmias. Sympatho-vagal balance seems to be disrupted in patients with GERD.