Authors: herreros, b.¹; ascaso, j. f.²; mora, f.¹; costa, a. j.³; sanchiz, v.¹; minguez, m.¹; benages, a.¹

Source: Neurogastroenterology and Motility, Volume 19, Number 8, August 2007 , pp. 646-652(7)

Publisher: Wiley-Blackwell

Abstract:

 

Extra-oesophageal autonomic dysfunction in idiopathic achalasia is not well documented, due to contradictory results reported. We aimed to study the cardiovascular and pancreatic autonomic function in patients with idiopathic achalasia. Thirty patients with idiopathic achalasia (16M/14F; 34.5 ± 10.8 years) and 30 healthy volunteers (13M/17F; 34.8 ± 10.7 years) were prospectively studied. Age >60 years and conditions affecting results of autonomic evaluation were excluded. Both groups underwent the sham feeding test and plasmatic levels of pancreatic polypeptide (PP) were determined by radioimmunoassay (basal, at 5, 10, 20 and 30 min). Cardiovascular parasympathetic (deep breathing, standing, Valsalva) and sympathetic function (postural decrease of systolic blood pressure, Handgrip test) were assessed. Statistical comparison of basal and increase levels of PP and parasympathetic/sympathetic cardiovascular parameters was performed between groups. Basal levels of PP were similar in controls and patients and maximum increase of PP during sham feeding test. A similar rate of abnormal cardiovascular tests was found between groups (P > 0.05). E/I ratio was the mostly impaired parameter (patients: 36.7%vs controls: 20%, P = 0.15, chi-squared test). Autonomic cardiovascular tests and pancreatic response to vagal stimulus are not impaired in patients with primary achalasia of the oesophagus.

Keywords: achalasia; autonomic cardiovascular test; autonomic neuropathy; pancreatic polypeptide; sham feeding

Document Type: Research article

DOI: http://dx.doi.org/10.1111/j.1365-2982.2007.00920.x

Affiliations: 1: Department of Gastroenterology, University Clinic Hospital, University of Valencia, Valencia, Spain 2: Department of Endocrinology, University Clinic Hospital, University of Valencia, Valencia, Spain 3: Health Technologies Assessment Unit, Conselleria de Sanitat, Generalitat Valenciana, Spain

Publication date: 2007-08-01

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