Otonom Sinir Sistemi Aktivitesinin Premenstrual Sendromla İlişkisi

Year 2020, Volume: 17 Issue: 2, 167 - 171, 20.08.2020

Tuba Özgöçer , Cihat Uçar , Sedat Yıldız

https://doi.org/10.35440/hutfd.699866

Abstract

Amaç: Çalışmanın amacı, premenstrual sendromlu bayanlarda menstrual siklusun menstrual ve premenstrual dönemlerinde kalp hızı değişkenliği ölçülerek, premenstrual stresin otonom sinir sistemi aktivitesi ile ilişkisini araştırmaktır.
Materyal ve Metod: Çalışmaya premenstrual sendrom tanı ölçeği (ACOG) krtiterlerine göre premenstrual semptom yaşadığı belirlenen ve yaşları 18-30 arasındaki İnönü Üniversitesi Tıp Fakültesi öğrencileri ve asistanlarından oluşan gönüllü bayanlar (n=68) dahil edilmiştir. Katılımcılara menstrual döngünün menstrual (1-3 gün) ve premenstrual (24-27 gün) dönemlerde bir gün kalp hızı değişkenliği analizi için 5 dakikalık EKG çekimi yapılmış ve kan basıncı ölçümleri yapılmıştır. Verilerin istatistiksel analizinde normal dağılım testi uygulanmıştır. Normal dağılım varsayımı sağlayan verilerin tekrarlı ölçümlerinde Paired t testi, normal dağılım varsayımı sağlamayan verilerin analizinde ise Friedman testi kullanılarak iki dönem karşılaştırılmıştır. p<0.05 değerleri anlamlı kabul edilmiştir.
Bulgular: Zaman bağımlı parametrelerden iki kalp atımı arasındaki süre ve QRS kompleksi aralıkları süresinin menstrual döneme göre premenstrual dönemde istatistiksel olarak daha düşük olduğu tespit edilmiştir (p<0.05). Frekans bağımlı parametrelerden ise yüksek frekans (normalize) ve % yüksek frekans premenstrual dönemde istatistiksel olarak daha düşük iken, düşük frekans (normalize) ve düşük frekans/ yüksek frekansın logaritmasının premenstrual dönemde istatistiksel olarak daha yüksek olduğu tespit edilmiştir (p<0.05).
Sonuç: Sempatik aktiviteyi yansıtan kalp hızı değişkenliği parametreleri menstrual döngünün premenstrual döneminde yükselmiştir. Elde edilen bulgulara göre sempatik aktivitede görülen değişiklikler premenstrual semptomların oluşmasına etken olabilmektedir.

Anahtar Kelimeler: Kalp hızı değişkenliği (KHD), otonom sinir sistemi aktivitesi, menstrual döngü, premenstrual semptom.

Keywords

Kalp hızı değişkenliği (KHD), otonom sinir sistemi aktivitesi, menstrual döngü, premenstrual semptom.

Supporting Institution

TÜBİTAK

Project Number

115S949

Relationship of Autonomic Nervous System Activity with Premenstrual Syndrome

Abstract

Background: The purpose of the present study was to investigate autonomy nervous system activity during the menses and premenstrual period of the menstrual cycle using heart rate variability in women with prementstrual syndrome.
Materials and methods: The study included volunteer women (n= 68), who were determined to have premenstrual symptoms according to the premenstrual syndrome diagnostic scale (ACOG), and who were between the ages of 18-30, students and assistants of Inonu University Medical Faculty. during the menses (1-3 days) and premenstrual (24-27 days) periods of the menstrual cycle, 5-minute ECG was taken and blood pressure measurements were made for one day heart rate variability analysis. In the statistical analysis of the data, normal distribution test was applied. Paired t test was used for repeated measurements of data providing normal distribution and Friedman test was used for analysis of data that did not provide normal distribution was used for the comparison of both phases of the menstrual cycle. p <0.05 values were accepted significant.
Results: It was determined that time between two heartbeats and duration of QRS complex intervals, which are time dependent parameters, were statistically lower in premenstrual period than menses (p <0.05). High frequency (normalized) and % high frequency were statistically lower in the premenstrual period, while the frequency dependent parameters were statistically higher in the low frequency (normalized) and log low frequency/ high frequency premenstrual period than menses (p<0.05).
Conclusion: Heart rate variability parameters reflecting sympathetic activity increased during the premenstrual period of the menstrual cycle. According to the findings changes in sympathetic activity may affect premenstrual symptoms to occur.

Keywords

Heart rate variability (HRV), autonomy nervous system activity, menstrual cycle, premenstrual symptom

Project Number

115S949

References

• 1. Aubert AE, Seps B, Beckers F. Heart rate variability in athletes. Sports medicine. 2003;33(12):889-919.
• 2. Marques AH, Silverman MN, Sternberg EM. Evaluation of stress systems by applying noninvasive methodologies: measurements of neuroimmune biomarkers in the sweat, heart rate variability and salivary cortisol. Neuroimmunomodulation. 2010;17(3):205-8.
• 3. Lombardi F, Malliani A, Pagani M, Cerutti S. Heart rate variability and its sympatho-vagal modulation. Cardiovascular research. 1996;32(2):208-16.
• 4. Mortara A, Sleight P, Pinna GD, Maestri R, Prpa A, La Rovere MT, et al. Abnormal awake respiratory patterns are common in chronic heart failure and may prevent evaluation of autonomic tone by measures of heart rate variability. Circulation. 1997;96(1):246-52.
• 5. Pinna GD, Maestri R, Mortara A, La Rovere MT. Cardiorespiratory interactions during periodic breathing in awake chronic heart failure patients. American journal of physiology Heart and circulatory physiology. 2000;278(3):H932-41.
• 6. Montano N, Ruscone TG, Porta A, Lombardi F, Pagani M, Malliani A. Power spectrum analysis of heart rate variability to assess the changes in sympathovagal balance during graded orthostatic tilt. Circulation. 1994;90(4):1826-31.
• 7. Michels N, Sioen I, Clays E, De Buyzere M, Ahrens W, Huybrechts I, et al. Children's heart rate variability as stress indicator: association with reported stress and cortisol. Biological psychology. 2013;94(2):433-40.
• 8. Gorman JM, Sloan RP. Heart rate variability in depressive and anxiety disorders. American heart journal. 2000;140(4 Suppl):77-83.
• 9. Stein PK, Carney RM, Freedland KE, Skala JA, Jaffe AS, Kleiger RE, et al. Severe depression is associated with markedly reduced heart rate variability in patients with stable coronary heart disease. Journal of psychosomatic research. 2000;48(4-5):493-500.
• 10. Yeragani VK, Pohl R, Jampala VC, Balon R, Ramesh C, Srinivasan K. Effects of nortriptyline and paroxetine on QT variability in patients with panic disorder. Depression and anxiety. 2000;11(3):126-30.
• 11. Malik M BJ, Camm A J, Kleiger RE, Malliani A, Moss AJ, Schwartz PJ. Heart rate variability. Standards of measurement, physiological interpretation, and clinical use. Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. European heart journal. 1996;17(3):354-81.
• 12. Strine TW, Chapman DP, Ahluwalia IB. Menstrual-related problems and psychological distress among women in the United States. Journal of women's health. 2005;14(4):316-23.
• 13. Lustyk MK, Widman L, Paschane A, Ecker E. Stress, quality of life and physical activity in women with varying degrees of premenstrual symptomatology. Women & health. 2004;39(3):35-44.
• 14. Girdler SS, Pedersen CA, Straneva PA, Leserman J, Stanwyck CL, Benjamin S, et al. Dysregulation of cardiovascular and neuroendocrine responses to stress in premenstrual dysphoric disorder. Psychiatry research. 1998;81(2):163-78.
• 15. Matsumoto T, Ushiroyama T, Kimura T, Hayashi T, Moritani T. Altered autonomic nervous system activity as a potential etiological factor of premenstrual syndrome and premenstrual dysphoric disorder. BioPsychoSocial medicine. 2007;1:24.
• 16. Ha JH, Park S, Yoon D, Kim B. Short-term heart rate variability in older patients with newly diagnosed depression. Psychiatry research. 2015;226(2-3):484-8.
• 17. Cirillo PC, Passos RB, Bevilaqua MC, Lopez JR, Nardi AE. Bipolar disorder and Premenstrual Syndrome or Premenstrual Dysphoric Disorder comorbidity: a systematic review. Braz J Psychiatry. 2012;34(4):467-79.
• 18. Hanrahan K, McCarthy AM, Kleiber C, Lutgendorf S, Tsalikian E. Strategies for salivary cortisol collection and analysis in research with children. Applied nursing research : ANR. 2006;19(2):95-101.
• 19. Brar TK, Singh KD, Kumar A. Effect of Different Phases of Menstrual Cycle on Heart Rate Variability (HRV). Journal of clinical and diagnostic research : JCDR. 2015;9(10):CC01-4.
• 20. Matsumoto T, Ushiroyama T, Morimura M, Moritani T, Hayashi T, Suzuki T, et al. Autonomic nervous system activity in the late luteal phase of eumenorrheic women with premenstrual symptomatology. Journal of psychosomatic obstetrics and gynaecology. 2006;27(3):131-9.