title: Cardiac autonomic dysfunction in patients with gastroesophageal reflux disease.
abstract: OBJECTIVE
  To investigate autonomic nervous function in patients with a diagnosis of gastroesophageal reflux disease (GERD).
  
  
  METHODS
  The investigation was performed on 29 patients (14 men), aged 18-80 years (51.14 ± 18.34), who were referred to our Neurocardiology Laboratory at the Clinical and Hospital Center "Bezanijska Kosa" with a diagnosis of GERD. One hundred sixteen healthy volunteers matched in age and sex with the examinees served as the control group. The study protocol included the evaluation of autonomic function and hemodynamic status, short-term heart rate variability (HRV) analysis, 24 h ambulatory ECG monitoring with long-term HRV analysis and 24 h ambulatory blood pressure monitoring.
  
  
  RESULTS
  Pathologic results of cardiovascular reflex test were more common among patients with reflux compared to the control group. Severe autonomic dysfunction was detected in 44.4% of patients and in 7.9% of controls (P < 0.001). Parameters of short-term analysis of RR variability, which are the indicators of vagal activity, had lower values in patients with GERD than in the control group. Long-term HRV analysis of time-domain parameters indicated lower values in patients with reflux disease when compared to the control group. Power spectral analysis of long-term HRV revealed lower low- and high-frequency values. Detailed 24 h ambulatory blood pressure analysis showed significantly higher values of systolic blood pressure and pulse pressure in the reflux group than in the control group.
  
  
  CONCLUSIONS
  Patients with GERD have distortion of sympathetic and parasympathetic components of the autonomic nervous system, but impaired parasympathetic function appears more congruent to GERD.
authors.affiliation: Branislav Milovanovic, Slavica Mutavdzin, Tatjana Gligorijevic, Jovana Paunovic, Marina Arsic, Department of Cardiology, Neurocardiology Laboratory, Clinical and Hospital Center "Bezanijska Kosa", Belgrade 11080, Republic of Serbia.
authors.forename: Branislav
authors.initials: B
authors.lastname: Milovanovic
authors.affiliation: Branislav Milovanovic, Slavica Mutavdzin, Tatjana Gligorijevic, Jovana Paunovic, Marina Arsic, Department of Cardiology, Neurocardiology Laboratory, Clinical and Hospital Center "Bezanijska Kosa", Belgrade 11080, Republic of Serbia.
authors.forename: Branka
authors.initials: B
authors.lastname: Filipovic
authors.affiliation: Branislav Milovanovic, Slavica Mutavdzin, Tatjana Gligorijevic, Jovana Paunovic, Marina Arsic, Department of Cardiology, Neurocardiology Laboratory, Clinical and Hospital Center "Bezanijska Kosa", Belgrade 11080, Republic of Serbia.
authors.forename: Slavica
authors.initials: S
authors.lastname: Mutavdzin
authors.affiliation: Branislav Milovanovic, Slavica Mutavdzin, Tatjana Gligorijevic, Jovana Paunovic, Marina Arsic, Department of Cardiology, Neurocardiology Laboratory, Clinical and Hospital Center "Bezanijska Kosa", Belgrade 11080, Republic of Serbia.
authors.forename: Marija
authors.initials: M
authors.lastname: Zdravkovic
authors.affiliation: Branislav Milovanovic, Slavica Mutavdzin, Tatjana Gligorijevic, Jovana Paunovic, Marina Arsic, Department of Cardiology, Neurocardiology Laboratory, Clinical and Hospital Center "Bezanijska Kosa", Belgrade 11080, Republic of Serbia.
authors.forename: Tatjana
authors.initials: T
authors.lastname: Gligorijevic
authors.affiliation: Branislav Milovanovic, Slavica Mutavdzin, Tatjana Gligorijevic, Jovana Paunovic, Marina Arsic, Department of Cardiology, Neurocardiology Laboratory, Clinical and Hospital Center "Bezanijska Kosa", Belgrade 11080, Republic of Serbia.
authors.forename: Jovana
authors.initials: J
authors.lastname: Paunovic
authors.affiliation: Branislav Milovanovic, Slavica Mutavdzin, Tatjana Gligorijevic, Jovana Paunovic, Marina Arsic, Department of Cardiology, Neurocardiology Laboratory, Clinical and Hospital Center "Bezanijska Kosa", Belgrade 11080, Republic of Serbia.
authors.forename: Marina
authors.initials: M
authors.lastname: Arsic
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001341:Autonomic Nervous System / Q000503:physiopathology*; D001342:Autonomic Nervous System Diseases / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D017704:Baroreflex; D001794:Blood Pressure; D018660:Blood Pressure Monitoring, Ambulatory; D016022:Case-Control Studies; D015716:Electrocardiography, Ambulatory; D005260:Female; D005764:Gastroesophageal Reflux / Q000150:complications* / Q000175:diagnosis; D006321:Heart / Q000294:innervation*; D006331:Heart Diseases / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D055771:Serbia; D013997:Time Factors; D055815:Young Adult
keywords: Autonomic nervous system; Blood pressure monitoring; Cardiovascular reflex test; ECG monitoring; Gastroesophageal reflux disease