title: Decreased parasympathetic activity in patients with functional dyspepsia.
abstract: OBJECTIVE
  Functional dyspepsia (FD) can be described as the presence of symptoms such as bothersome postprandial fullness, early satiation, epigastric pain, and burning without any evidence of structural disease. The aim of this study was to evaluate the autonomic nervous system using heart rate variability (HRV) in patients with postprandial distress syndrome and epigastric pain syndrome.
  
  
  METHODS
  The study population included 64 consecutive patients with a diagnosis of FD and 62 age-matched and sex-matched healthy control individuals with no clinical evidence of gastrointestinal, systemic, or cardiovascular diseases. All patients underwent upper gastrointestinal endoscopy and 24 h Holter monitoring.
  
  
  RESULTS
  There were 30 patients with postprandial distress syndrome and 34 with epigastric pain syndrome. Twenty-four hour square root of the mean squared differences of the successive normal to normal intervals (RMSSD) (30.5 ± 12.4, 35.8 ± 13.9; P=0.047), 24 h proportion derived by dividing the number of interval differences of successive normal to normal intervals greater than 50 ms (PNN50) (9.8 ± 3.9, 14.1 ± 7.3; P=0.017), daytime PNN50 (6.8 ± 1.6, 18.4 ± 13.8; P<0.001), night SD of the normal to normal intervals (SDNN) (111.4 ± 39.9, 133.4 ± 29.8; P=0.001), and night RMSSD (31.7 ± 12.4, 38.2 ± 17.5; P=0.019) were significantly lower in patients with FD than controls. Other HRV parameters were not significantly different between the two groups. Changes in these parameters showed a decreased parasympathetic tone and discordance in sympathovagal activity in FD.
  
  
  CONCLUSIONS
  Our study showed decreased parasympathetic activity in the patients with FD. Further studies are required to evaluate the significance of HRV parameters and to clarify the mechanism of decreased parasympathetic activity in patients with FD.
authors.affiliation: Departments of aInternal Medicine bCardiology, Kecioren Teaching and Research Hospital, Ankara, Turkey.
authors.forename: Kursat
authors.initials: K
authors.lastname: Dal
authors.forename: Onur S
authors.initials: OS
authors.lastname: Deveci
authors.forename: Metin
authors.initials: M
authors.lastname: Kucukazman
authors.forename: Naim
authors.initials: N
authors.lastname: Ata
authors.forename: Omer
authors.initials: O
authors.lastname: Sen
authors.forename: Selcuk
authors.initials: S
authors.lastname: Ozkan
authors.forename: Abdullah O
authors.initials: AO
authors.lastname: Yeniova
authors.forename: Salih
authors.initials: S
authors.lastname: Başer
authors.forename: Esin
authors.initials: E
authors.lastname: Beyan
authors.forename: Yaşar
authors.initials: Y
authors.lastname: Nazligul
authors.forename: Bunyamin
authors.initials: B
authors.lastname: Yavuz
authors.forename: Derun T
authors.initials: DT
authors.lastname: Ertugrul
mesh_terms: D059787:Acute Pain / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology; D000328:Adult; D004415:Dyspepsia / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology*; D004452:Echocardiography; D015716:Electrocardiography, Ambulatory; D016145:Endoscopy, Digestive System; D001068:Feeding and Eating Disorders / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology; D005260:Female; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010275:Parasympathetic Nervous System / Q000503:physiopathology*; D019518:Postprandial Period / Q000502:physiology; D014630:Vagus Nerve / Q000503:physiopathology