Cardiac and autonomic function in patients with Crohn’s disease during remission

Zawadka‐Kunikowska, Monika; Słomko, Joanna; Kłopocka, Maria; Liebert, Ariel; Tafil-Klawe, Małgorzata; Klawe, Jacek J.; Newton, Julia L.; Zalewski, Paweł

doi:10.1016/j.advms.2018.04.009

Cited by 8 publications

(4 citation statements)

References 30 publications

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“…The ECG and blood pressure waveforms acquisition was performed by Task Force© Monitor (TFM), CNSystems Medizintechnik GmbH, Graz, Austria (CNS) ( Kocabas et al, 2018 ; CNSystems, 2020 ), which also provides beat-to-beat R–R interval (RRI) and its inverse hear rate (HR) time series, as well as beat-to-beat systolic and diastolic blood pressure (sBP, dBP) by the vascular unloading technique ( Gratze et al, 1998 ; Parati et al, 2003 ), which was corrected automatically to the oscillometric blood pressure measured on the contralateral arm ( Zawadka-Kunikowska et al, 2018 ).…”

Section: Methodsmentioning

confidence: 99%

Assessment of Autonomic Nervous System Dysfunction in the Early Phase of Infection With SARS-CoV-2 Virus

et al. 2021

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BackgroundWe are facing the outburst of coronavirus disease 2019 (COVID-19) defined as a serious, multisystem, disorder, including various neurological manifestations in its presentation. So far, autonomic dysfunction (AD) has not been reported in patients with COVID-19 infection.AimAssessment of AD in the early phase of infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 virus).Patients and methodsWe analyzed 116 PCR positive COVID-19 patients. After the exclusion of 41 patients with associate diseases (CADG), partitioned to patients with diabetes mellitus, hypertension, and syncope, the remaining patients were included into a severe group (45 patients with confirmed interstitial pneumonia) and mild group (30 patients). Basic cardiovascular autonomic reflex tests (CART) were performed, followed by beat-to-beat heart rate variability (HRV) and systolic and diastolic blood pressure variability (BPV) analysis, along with baroreceptor sensitivity (BRS). Non-linear analysis of HRV was provided by Poincare Plot. Results were compared to 77 sex and age-matched controls.ResultsAD (sympathetic, parasympathetic, or both) in our study has been revealed in 51.5% of severe, 78.0% of mild COVID-19 patients, and the difference compared to healthy controls was significant (p = 0.018). Orthostatic hypotension has been established in 33.0% COVID-19 patients compared to 2.6% controls (p = 0.001). Most of the spectral parameters of HRV and BPV confirmed AD, most prominent in the severe COVID-19 group. BRS was significantly lower in all patients (severe, mild, CADG), indicating significant sudden cardiac death risk.ConclusionCardiovascular autonomic neuropathy should be taken into account in COVID-19 patients’ assessment. It can be an explanation for a variety of registered manifestations, enabling a comprehensive diagnostic approach and further treatment.

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Section: Methodsmentioning

confidence: 99%

Assessment of Autonomic Nervous System Dysfunction in the Early Phase of Infection With SARS-CoV-2 Virus

et al. 2021

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“…Among IBD patients, UC patients exhibit high sympathetic (15)(16)(17) and low vagal tone related to negative affects compared to healthy individuals (18). CD patients also present higher sympatheticparasympathetic ratio compared to control individuals, which can be explained by an increase in sympathetic activity (19). However, the overactivity of the HPA axis in patients with gastrointestinal pathologies remains controversial.…”

Section: Introductionmentioning

confidence: 99%

Interoceptive Abilities in Inflammatory Bowel Diseases and Irritable Bowel Syndrome

et al. 2020

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Alexithymia is usually described by three main dimensions difficulty identifying feelings (DIF), difficulty describing feelings (DDF), and externally oriented thinking (EOT). The most commonly used questionnaire investigating alexithymia, the Toronto Alexithymia Scale (TAS-20), supports this three-factor structure. One important assumption is that alexithymia severity is associated to vulnerability to somatic diseases, among them gastrointestinal disorders. However, the association between alexithymia and gastrointestinal disorders is not systematic, thus questioning the role of alexithymia as a vulnerability factor for those illnesses. A recent factor analysis suggested another fourfactor structure for the TAS-20: difficulties in awareness of feelings (DAF), difficulties in interoceptive abilities (DIA), externally oriented thinking (EOT), and poor affective sharing (PAS). We assume that DIA and DAF might be more relevant to investigate the association between alexithymia and gastrointestinal disorders. The rationale is that DIA and DAF reflect impairments in emotion regulation that could contribute to an inappropriate autonomic and HPA axis homeostasis in irritable bowel syndrome (IBS), ulcerative colitis (UC), or Crohn's disease (CD). The aim of this study was to investigate whether DIA and DAF are associated with the presence of IBS, UC or CD, while checking for anxiety, depression, parasympathetic (vagus nerve) activity and cortisol levels. We recruited control participants (n=26), and patients in remission who were diagnosed with IBS (n=24), UC (n=18), or CD (n=21). Participants completed questionnaires to assess anxiety, depression, and alexithymia. A blood sample and an electrocardiogram were used to measure the level of cortisol and parasympathetic activity, respectively. Logistic regressions with the four-factor structure of the TAS-20 revealed that DIA was a significant predictor of IBS (W(1)=6.27, p=.01). Conversely, DIA and DAF were not significant predictors in CD and UC patients. However, low cortisol level was a Frontiers in Psychiatry | www.frontiersin.org

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“…According to Ganguli et al in 2007, patients with UC but not CD showed more sympathetic activity compared to controls [ 40 ]. In a recent study, CD patients in remission exhibited a considerably larger sympathetic–parasympathetic ratio, according to Zawadka-Kunikowska et al [ 41 ].…”

Section: Possible Role Of Vagus Nerve Stimulation In Chronic Inflamma...mentioning

confidence: 99%

Inflammatory Bowel Disease: Role of Vagus Nerve Stimulation

Fornaro

Actis

Caviglia

et al. 2022

JCM

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Vagus nerve stimulation (VNS) is an accepted therapy for the treatment of refractory forms of epilepsy and depression. The brain–gut axis is increasingly being studied as a possible etiological factor of chronic inflammatory diseases, including inflammatory bowel diseases (IBD). A significant percentage of IBD patients lose response to treatments or experience side effects. In this perspective, VNS has shown the first efficacy data. The aim of this narrative review is to underline the biological plausibility of the use of VNS in patients affected by IBD, collect all clinical data in the literature, and hypothesize a target IBD population on which to focus the next clinical study.

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Cardiac and autonomic function in patients with Crohn’s disease during remission

Cited by 8 publications

References 30 publications

Assessment of Autonomic Nervous System Dysfunction in the Early Phase of Infection With SARS-CoV-2 Virus

Assessment of Autonomic Nervous System Dysfunction in the Early Phase of Infection With SARS-CoV-2 Virus

Interoceptive Abilities in Inflammatory Bowel Diseases and Irritable Bowel Syndrome

Inflammatory Bowel Disease: Role of Vagus Nerve Stimulation

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