İrritabıl Barsak Sendromunda Otonomik Fonksiyon Değerlenirmede Yeni Bir Belirteç Olarak Kalp Hızı Toparlanma İndeksi

Yıl 2021, Cilt: 11 Sayı: 2, 288 - 292, 29.06.2021

Muhammed N Murat Aksoy , Ceyhun Varım , Cengiz Karacaer , Perihan Varım

https://doi.org/10.31832/smj.801970

Öz

AMAÇ: İrritabıl barsak sendromunda (IBS) otonomik fonksiyon değerlendirilmesi ile ilgili yapılan çalışmalarda sıklıkla kalp hızı değişkenliği indeksi kullanılmış ve çelişkili sonuçlar elde edilmiştir. Biz bu çalışmada kalp hızı toparlanma indeksini (KHTİ) bu hasta grubunda otonom fonksiyon değerlendirmesinde yeni bir belirteç olarak önerdik ve çalıştık
YÖNTEM: Çalışmaya 35 adet IBS hastası ile yaş ve cinsiyet açısından eşitlenmiş 35 adet sağlıklı kontrol hastası dahil edildi. Bütün hastalara transtorasik ekokardiyografi ve modifiye Bruce protokolü ile egzersiz ekg testi (efor testi) uygulandı. KHTİ ölçümleri egzersiz testi ani şekilde sonlandırıldıktan sonraki 1. ve 2. Dakikalarda ölçülerek kayıt altına alındı.
BULGULAR: IBS ve kontrol hasta grubu yaş, cinsiyet, hipertansiyon ve sigara içiciliği açısından karşılaştırıldığında birbirlerine benzerdi. Vücut kitle indeksi ölçümlerinde IBS grubu istatiksel anlamlı olarak daha düşük ölçülere sahipti (26±3 vs 28±5, p=0.028). KHTİ ölçümleri açısından iki grup arasında anlamlı fark saptanmadı (IBS; 34±11 vs Kontrol; 36±11, p=0.459).
SONUÇ: KHTİ göz önüne alındığında, otonom fonksiyon bozukluğu İBS hastalarında primer fizyopatolojik sebep olmayabilir.

Anahtar Kelimeler

irritabıl barsak sendromu, kalp hızı toparlanma indeksi, otonomik disfonksiyon

Heart Rate Recovery Index as a Novel Indicator of Autonomic Status in Irritable Bowel Syndrome

Öz

Objective: There are numerous studies with conflicting results using heart rate variability as a marker for parasympathetic dysfunction in irritable bowel syndrome. In this study we aim to investigate heart rate recovery as a new tool to document autonomic status in IBS patients.
Methods: We enrolled 35 IBS patients and 35 healthy age and sex matched controls in the study. All patients underwent transthoracic echocardiography and exercise ecg test with modified bruce protocol. Heart rate recovery measurements were taken at first and second minute after abrupt cessation of exercise.
Results: IBS and control group were similar with respect to age, sex, hypertension and smoking status except BMI which was lower in IBS group. (26±3 vs 28±5, p=0.028). HRR values did not differ statistically between groups (IBS;34±11 vs Control;36±11, p=0,459).
Conclusions: Our results suggest that autonomic imbalance might not be the primary pathophysiological mechanism in IBS patients according to HRR index.
Keywords: heart rate recovery index, irritable bowel syndrome, autonomic dysfunction

Anahtar Kelimeler

heart rate recovery index, irritable bowel syndrome

Kaynakça

• REFERENCES 1. Mayer EA, Naliboff BD, Chang L. Basic pathopysiological mechanisms in irritable bowel syndrome. Dig Dis 2001; 19:212-8
• 2. Karling P, Nyhlin P, Wiklund U, Sjöberg M, Olofsson BO, Bjerle P. Spectral analysis of heart rate variability in patients with irritable bowel syndrome. Scand J Gastroenterol. 1998 ;33(6):572-6.
• 3. Adeyemi EO, Desai KD, Towsey M, Ghista D. Characterization of autonomic dysfunction in patients with irritable bowel syndrome by means of heart rate variability studies. Am J Gastroenterol. 1999 ;94(3):816-23.
• 4. Salvioli B, Pellegatta G, Malacarne M, Pace F, Malesci A, Pagani M et al Autonomic nervous system dysregulation in irritable bowel syndrome. Neurogastroenterol Motil. 2015 ;27(3):423-30
• 5. Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. Heart rate variability: standarts of measurement, physiological interpretation and clinical use. Circulation 1999; 93:1043-65
• 6. Kannankeril P, Le F, Kadish A, Goldberger J. Parasympathetic effects on heart rate recovery after exercise. J Investig Med 2004; 52:394-401
• 7. Sundaram S, Shoushtari C, Carnethon M, Kadish A, Goldberger J. Autonomic and nonautonomic determinants of heart rate recovery. Heart Rhythm 2004;1:S100-1
• 8. Emren V, Kocabaş U. Is heart rate recovery index a predictive factor for cardioinhibitory syncope? Kardiol Pol. 2018;76(2):347-352.
• 9. Cole CR, Blackstone EH, Pashkow FJ, Snader CE, Lauer MS. Heart-rate recovery immediately after exercise as a predictor of mortality. N Engl J Med. 1999 Oct 28;341(18):1351-7.
• 10. Cole CR, Foody JM, Blackstone EH, Lauer MS. Heart rate recovery after submaximal exercise testing as a predictor of mortality in a cardiovascularly healthy cohort. Ann Intern Med. 2000 Apr 4;132(7):552-5.
• 11. Liu Q, Wang EM, Yan XJ, Chen SL. Autonomic functioning in irritable bowel syndrome measured by heart rate variability: a meta-analysis. J Dig Dis. 2013 Dec;14(12):638-46.
• 12. Mazurak N, Seredyuk N, Sauer H, Teufel M, Enck P. Hear rate variability in the irritable bowel syndrome: a review of the literature. Neurogastroenterol Motil. 2012; 24: 206-216
• 13. Azam F, Shaheen A, Irshad K, Liaquat A, Naveed H, Shah SU. Association of postexercise heart rate recovery with body composition in healthy male adults: Findings from Pakistan. Ann Noninvasive Electrocardiol. 2020 May;25(3):e12711.