Postprandial cardiac vagal tone and transient lower esophageal sphincter relaxation (TLESR)

作者：Kuo P; Bravi I; Marreddy U; Aziz Q; Sifrim D^*

来源：Neuro-Gastroenterology and Motility, 2013, 25(10): 841-+.

DOI：10.1111/nmo.12195

• autonomic nerve
• LES
• reflux
• vagal tone

BackgroundTransient lower esophageal sphincter relaxation (TLESR) is a vagally mediated reflex that occurs most frequently after a meal. Cardiac vagal tone (CVT) decreases after a meal, and correlates with changes in gastric electrical activity. Furthermore, decreased CVT has been reported in patients with gastro-esophageal reflux disease. We therefore aimed to characterize the association between postprandial changes in CVT and the occurrence of TLESR and reflux. %26lt;br%26gt;MethodsTen healthy volunteers underwent simultaneous autonomic nervous system, gastric myoelectric activity, lower esophageal-sphincter pressure, and reflux monitoring for 30min in the fasting state, followed by a standard meal, and a further 4h postprandially. Results are in meanSEM. %26lt;br%26gt;Key ResultsThe number of TLESRs (P%26lt;0.0001) and reflux episodes (P%26lt;0.0001) increased after the meal, while CVT decreased (P%26lt;0.01). Cardiac sensitivity to baroreceptor reflex (CSB) showed similar time course changes to CVT (P=0.06). During the first postprandial hour there was a strong correlation between the number of TLESRs and reflux episodes with CVT (R-2=0.51 and R-2=0.50, respectively; P%26lt;0.05). There was also an increase in the dominant power and power ratio on electrogastrography (P%26lt;0.05) after the meal. %26lt;br%26gt;Conclusions %26 InferencesIn healthy volunteers, the increase in the number of TLESRs and reflux episodes after a meal occurred mostly at a time of reduced CVT. Further studies should explore whether modulation of CVT can modify frequency of TLESRs and also this relationship should be further explored in patients with reflux disease.

• 出版日期2013-10