Key result
Achalasia was associated with significant alterations in heart rate and blood pressure variability compared to healthy controls, indicating parasympathetic damage to the heart and cardiovascular dysautonomia.
Why the study?
Achalasia is associated with extraesophageal dysmotility, suggesting autonomic nervous system alterations that may extend beyond the esophagus to include blood pressure and heart rate abnormalities.
Does achalasia cause alterations in heart rate and blood pressure variability compared to healthy controls?
Cross-Sectional (n=48)
Does achalasia cause alterations in heart rate and blood pressure variability compared to healthy controls?
Achalasia is associated with significant alterations in heart rate and blood pressure variability, suggesting a generalized disturbance of the autonomic nervous system affecting cardiovascular function.
May indicate need for autonomic assessment in achalasia; hypothesis-generating and should not yet change practice.
Achalasia is a disease characterized by the inability to relax the esophageal sphincter due to a degeneration of the parasympathetic ganglion cells located in the wall of the thoracic esophagus. Achalasia has been associated with extraesophageal dysmotility, suggesting alterations of the autonomic nervous system (ANS) that extend beyond the esophagus. The purpose of the present contribution is to investigate whether achalasia may be interpreted as the esophageal manifestation of a more generalized disturbance of the ANS which includes alterations of heart rate and/or blood pressure. Therefore simultaneous non-invasive records of the heart inter-beat intervals (IBI) and beat-to-beat systolic blood pressure (SBP) of 14 patients (9 female, 5 male) with achalasia were compared with the records of 34 rigorously screened healthy control subjects (17 female, 17 male) in three different conditions: supine, standing up, and controlled breathing at 0.1 Hz, using a variety of measures in the time and spectral domains. Significant differences in heart rate variability (HRV) and blood pressure variability (BPV) were observed which seem to be due to cardiovagal damage to the heart, i.e., a failure of the ANS, as expected according to our hypothesis. This non-invasive methodology can be employed as an auxiliary clinical protocol to study etiology and evolution of achalasia, and other pathologies that damage ANS.
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Rivera et al. (2021) conducted a cross-sectional in Achalasia (n=48). Achalasia vs. Healthy controls was evaluated on Heart rate variability (inter-beat intervals) and systolic blood pressure variability in time and frequency domains. Achalasia was associated with significant alterations in heart rate and blood pressure variability compared to healthy controls, indicating parasympathetic damage to the heart and cardiovascular dysautonomia.
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