Evaluation of autonomic nervous system functions in frame of heart rate variability in children with inflammatory bowel disease in remission

Özet

Heart Rate Variability (HRV) is one of the reliable and noninvasive parametersto evaluate autonomic control of the cardiovascular system in patients. Theaim of our study was to assess autonomic function in pediatric patientswith inflammatory bowel disease (IBD) in remission using Power SpectralAnalysis of HRV. Autonomic cardiovascular function was evaluated bytime and frequency-domain indexes of spontaneous heart rate in 36 IBDchildren patients in remission phase and 36 sex and age matched healthycontrols. Twenty children with Ulcerative Colitis (UC) and 16 patients withCrohn’s disease (CD) were diagnosed according to their history, physicaland laboratory examination, endoscopic, histopathological and radiologicalfindings of upper and lower gastrointestinal system. Significant decrease wasobserved at HRV parameters in IBD patients when compared with controlgroup. These differences was found in some of time domain parameters(NNmean, SDNNtotal, SDNNday) and frequency domain parameters (TP,LF,VLF) (p<0.05). Also, there was a significant higher minimum heart rateratio (p<0.04) in patients in comparison to the control group. In the IBDgroup, there was a relative tendency for parasympathetic suppression andsympathetic predominance which reflects an autonomic dysfunction. Thisimbalance has a circadian rhythm and it is more obvious during the day.These observations may suggest a previously unrecognized role of chronicinflammation for autonomic modulation in IBD.