Heart rate variability characteristics of patients with irritable bowel syndrome and associations with symptoms

Polster, Annikka; Friberg, Peter; Gunterberg, Veronica; Öhman, Lena; Nevé, Boris Le; Törnblom, Hans; Cvijović, Marija; Simrén, Magnus

doi:10.1111/nmo.13320

Cited by 23 publications

(33 citation statements)

References 65 publications

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“…A manual cleaning of the HRV recordings was done by a physician (AP) to remove artefacts and to ensure the correct registration of individual heartbeats and control for any cardiac pathologies; thereafter, a computer analysis followed (Impresario CardioNavigator Plus; Spacelabs Healthcare Ltd) to extract the measures used in this study. The protocol is described in detail elsewhere …”

Section: Methodsmentioning

confidence: 99%

“…The protocol is described in detail elsewhere. 20 The HRV measures used in the analyses of this study was measured during the first 5 minutes after standing up (ANS balance) and during the 24 hours without intervention. The ANS balance was calculated by dividing the low frequency (0.016-0.15 Hz) by high frequency (0.15-0.40 Hz) HRV, where the low frequency is considered to measure both sympathetic and parasympathetic neural modulation of the heart rate and the high frequency is considered as a measure of the parasympathetic activity.…”

Section: The Hrv Measurements Were Obtained From a 3-channel 24 Hoursmentioning

confidence: 99%

“…The pathophysiology of IBS is complex and incompletely understood, but studies have demonstrated abnormal gastrointestinal (GI) sensitivity, motility, and permeability in subsets of IBS patients, as well as dysregulation of the gut‐brain axis . Moreover, aberrant immune function, gut microbiota alterations, and dysregulation of the autonomic nervous system (ANS) have also been shown in a subset of IBS patients . However, the relative importance of an interaction between these pathogenetic and pathophysiologic factors for symptom generation in IBS is still not well described.…”

Section: Introductionmentioning

confidence: 99%

“…16 Moreover, aberrant immune function, 17 gut microbiota alterations, 18,19 and dysregulation of the autonomic nervous system (ANS) have also been shown in a subset of IBS patients. 20,21 However, the relative importance of an interaction between these pathogenetic and pathophysiologic factors for symptom generation in IBS is still not well described.…”

Section: Introductionmentioning

confidence: 99%

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Anxiety and depression in irritable bowel syndrome: Exploring the interaction with other symptoms and pathophysiology using multivariate analyses

Midenfjord

Polster

Sjövall

et al. 2019

Neurogastroenterology Motil

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Background Anxiety or depression, in other words, psychological distress, are common comorbidities in patients with irritable bowel syndrome (IBS), but their interaction with pathophysiological factors and other symptoms are unclear. Methods Patients with IBS (Rome III criteria), thoroughly characterized regarding pathophysiology (colonic transit time, visceral sensitivity, and autonomic nervous system [ANS] function), symptom profile (IBS severity, somatic symptoms, gastrointestinal [GI]‐specific anxiety and fatigue), and quality of life, were explored for differences regarding pathophysiology and symptoms between patients with and without reported psychological distress in univariate and multivariate analyses (Principal Component Analysis [PCA] with Hotelling's T2 and Orthogonal Partial Least Squares‐Discriminant Analysis [OPLS‐DA]). Key Results When using Hospital Anxiety and Depression Scale score ≥8 as cut‐off score, including both borderline and clinically significant cases, 345 (44.9%) out of 769 IBS patients reported anxiety, and 198 (25.7%) depression. In univariate analyses, patients reporting psychological distress demonstrated more severe GI and non‐GI symptoms, fatigue, GI‐specific anxiety and lower quality of life, and differences for some pathophysiological measures. IBS patients with and without reported psychological distress showed significant differences between the multivariate means in symptom reporting (PCA; both P < 0.001), and in pathophysiological measures in patients with and without anxiety (P = 0.018). Visceral hypersensitivity, altered ANS function, more severe GI‐specific anxiety, fatigue, and higher somatic non‐GI symptoms were the factors that most strongly separated patients with and without psychological distress (OPLS‐DA). Conclusions and Inferences Reported anxiety and depression are common in IBS patients, and our study demonstrates that they are interwoven in the complex pathophysiological and clinical picture of IBS.

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Section: Methodsmentioning

confidence: 99%

Section: The Hrv Measurements Were Obtained From a 3-channel 24 Hoursmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Anxiety and depression in irritable bowel syndrome: Exploring the interaction with other symptoms and pathophysiology using multivariate analyses

Midenfjord

Polster

Sjövall

et al. 2019

Neurogastroenterology Motil

Self Cite

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“…The high‐frequency (HF) spectrum of heart rate variability (HRV) is a non‐invasive way to measure vagal tone and can be calculated based on electrocardiogram (ECG) recordings, using a fast Fourier transformation of inter‐beat interval (IBI) values for both time‐ and frequency‐domain analysis . Previous studies have shown that changes in HRV are indicative of increased pathological risk and all‐cause mortality . Specifically, we have shown that preterm neonates that later develop NEC show a decrease in HF‐HRV power prior to the onset of clinical signs, as compared to healthy controls, making it an ideal non‐invasive predictive biomarker of NEC.…”

Section: Introductionmentioning

confidence: 99%

Ghrelin ameliorates the phenotype of newborn rats induced with mild necrotizing enterocolitis

Meister

Burkholder

Doheny

et al. 2019

Neurogastroenterology Motil

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Background We have shown previously that an attenuated rodent model of mild necrotizing enterocolitis (NEC) increases intestinal histopathological severity grade, prevents typical developmental increases in the high‐frequency spectrum of heart rate variability (HF‐HRV), alters the nitrergic myenteric phenotype, and increases IL‐6 and IL‐1β when combined with anterior subdiaphragmatic vagotomy. The aims of the present study were to test the hypotheses that in mild NEC‐induced pups, administration of the orexigenic hormone ghrelin (a) reduces the histopathological score, (b) increases the HF‐HRV power, (c) improves the altered myenteric phenotype, and (d) subdiaphragmatic vagotomy prevents the effects of ghrelin. Methods Newborn Sprague Dawley rats were subjected to seven days of brief periods of cold stress and hypoxia to induce mild NEC with or without anterior subdiaphragmatic vagotomy. HRV was measured at postnatal days one, five, and ten; intraperitoneal ghrelin (0.05 mg kg−1) was administered postnatal days five through ten b.i.d. Pups were sacrificed at day 12, and whole brains, gastrointestinal tissues, and blood were collected for immunohistochemical, corticosterone, and cytokine analysis. Key Results Ghrelin treatment reduced the intestinal histopathological score, increased the HF‐HRV power, improved the altered intestinal myenteric phenotype, and subdiaphragmatic vagotomy prevented the effects of ghrelin. There were no differences in serum cytokines or corticosterone between groups. Conclusions and Inferences Our data suggest that ghrelin administration is able to recover the mild NEC‐induced changes to the histology, HF‐HRV, and myenteric phenotype in a vagally dependent manner.

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Stress Response Pattern of Heart Rate Variability in Patients with Functional Somatic Syndromes

Saka-Kochi,

Kanbara,

Yoshida

et al. 2023

Appl Psychophysiol Biofeedback

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Heart rate variability characteristics of patients with irritable bowel syndrome and associations with symptoms

Abstract: Altered ANS function was demonstrated in patients with IBS, and this might be of particular relevance for symptoms in a subset of the patients.

Cited by 23 publications

References 65 publications

Anxiety and depression in irritable bowel syndrome: Exploring the interaction with other symptoms and pathophysiology using multivariate analyses

Anxiety and depression in irritable bowel syndrome: Exploring the interaction with other symptoms and pathophysiology using multivariate analyses

Ghrelin ameliorates the phenotype of newborn rats induced with mild necrotizing enterocolitis

Stress Response Pattern of Heart Rate Variability in Patients with Functional Somatic Syndromes

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