Cardiovascular response to sustained handgrip test in gastroesophageal reflux disease patients

Abstract

Background: Gastroesophageal reflux disease pathogenesis may be associated with disturbances of the autonomic nervous system.Methods: One hundred five participants aged 35-45 years of either sex, which include Gastroesophageal reflux disease patients, thirty five each (who presented typical symptom of Gastroesophageal reflux disease with reflux esophagitis (ERD) and without reflux esophagitis (NERD)) and thirty five age and sex matched control subjects, were enrolled in the study. Autonomic function test was assessed using Sustained Handgrip test.Results: In the present study, no significant difference was observed in age, height, weight, body mass index, resting systolic blood pressure and diastolic blood pressure between the study groups. The mean difference of diastolic blood pressure (mmHg) response to Sustained Handgrip test between ERD and NERD; ERD and Control; NERD and Control was statistically highly significant (p=0.001; p<0.001; p=0.029, respectively), predicting reduced sympathetic activity in gastroesophageal reflux disease, more in patients with reflux esophagitis (ERD).Conclusions: Reduced sympathetic activity can cause impairment of lower esophageal sphincter function, particularly of the neural mechanisms related to control of transient lower esophageal sphincter relaxation. It might increase number and time duration of transient lower esophageal sphincter relaxations resulting in pathological enhancement of GERD.