Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “cardiac autonomic function”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 361 records · Page 20Linked to original sources
PubMed2003

Assessment of cardiovascular autonomic function in myotonic dystrophy type 2 (DM2/PROMM).

BACKGROUND: Proximal myotonic myopathy is an autosomal dominant multisystem disorder with a recently defined CCTG expansion on chromosome 3 in the major subgroup (myotonic dystrophy type 2). Cardiac rhythm disturbances have been described in patients with this disease, but it is not known whether myotonic dystrophy type 2/proximal myotonic myopathy patients suffer from dysautonomia and whether cardiac arrhythmias relate to autonomic dysfunction. OBJECTIVES: To investigate cardiovascular autonomic function in myotonic dystrophy type 2/proximal myotonic myopathy patients with and without cardiac arrhythmias. PATIENTS AND METHODS: Standard autonomic function tests (heart rate responses to Valsalva manoeuvre, deep breathing and active change of posture, and blood pressure responses to active change of posture and sustained handgrip), resting heart rate variability in the time- and frequency-domain, and the corrected QT interval length were determined in 16 patients with genetically defined myotonic dystrophy type 2/proximal myotonic myopathy and compared to the results obtained in 16 age- and sex-matched healthy control subjects. RESULTS: Standard autonomic tests yielded similar results in both groups. Measures of heart rate variability tended to be lower in myotonic dystrophy type 2/proximal myotonic myopathy patients compared to healthy controls, but reached statistical significance only for the number of R-R intervals exceeding 50 ms (p50) and the power spectrum density in the low-frequency range (low-frequency power). Four patients (25%) suffered from mild cardiac rhythm disturbances encompassing paroxysmal tachycardia, sinoatrial block, right bundle branch block, ventricular premature beats and bradycardia. The autonomic responses of these patients were essentially similar compared to those without cardiac arrhythmias, apart from a decreased heart rate response to deep breathing in the patients with cardiac arrhythmias. CONCLUSIONS: We found no major abnormalities of cardiovascular autonomic function in patients with myotonic dystrophy type 2/proximal myotonic myopathy, neither in the whole study group nor in the subgroup of patients with cardiac rhythm abnormalities.

Adult↗
PubMed2005

QT interval abnormalities are often present at diagnosis in diabetes and are better predictors of cardiac death than ankle brachial pressure index and autonomic function tests.

OBJECTIVES: To study serial measures of maximum QT interval corrected for heart rate (QTc) and QT dispersion (QTD) and their association with cardiac mortality patients with non-insulin dependent diabetes and to compare QT abnormalities with other mortality predictors (ankle brachial pressure index (ABPI) and autonomic function tests) in their ability to predict cardiac death. SETTING: Teaching hospital. METHODS AND PATIENTS: QT interval analysis, heart rate (RR) variation in response to deep breathing and standing, and ABPI were analysed in 192 patients with non-insulin dependent diabetes. Cardiac death was the primary end point. RESULTS: Mean (SD) follow up was 12.7 (3.2) years (range 1.2-17.1 years). There were 48 deaths, of which 26 were cardiac. QTc and QTD were individually significant predictors of cardiac mortality throughout the follow up period (p < 0.001). The predictability of QT parameters was superior to the predictability of ABPI and RR interval analysis. Temporal changes in QT parameters showed that the mean absolute QT parameter was a significant predictor of cardiac death (p < 0.001), whereas an intraindividual change in QT parameter over time was not predictive. CONCLUSION: QT abnormalities seem to exist at the point of diagnosis of diabetes and do not appear to change between then and the subsequent cardiac death. Furthermore, the analysis of QT interval is superior to ABPI and the RR interval in identifying diabetic patients at high risk of cardiac death.

Adult↗
PubMed1969

Autonomic blockade by propranolol and atropine to study intrinsic myocardial function in man.

Blockade of cardiac autonomic nervous activity by an intravenous injection of 0.2 mg/kg propranolol and 0.04 mg/kg atropine was used with cardiac catheterization to study intrinsic cardiac function in 47 patients with normal hearts and known graded myocardial disease. After blockade, significant hemodynamic abnormalities became apparent at rest in the majority of patients with known disease, many of whom had normal control findings. This occurred partly through a reduction in the normal range of cardiac function at rest, and partly through changes in the abnormalities associated with disease: after blockade, diseased hearts had normal stroke volumes, but beat more slowly, and had higher left ventricular filling pressures. The heart rate after blockade was fixed; this was defined as the intrinsic heart rate (IHR); it ranged from 57 to 126 beats/min in different patients. Both the IHR and left ventricular end-diastolic pressure after blockade were sensitively and quantitatively related to the severity of myocardial disease. When, after blockade, arterial pressure was raised by angiotensin, the IHR was unchanged; normal hearts maintained their stroke volume and increased stroke work; diseased hearts maintained stroke volume less well and stroke work was unchanged or fell. Abnormal ventricular responses corresponded well with abnormal ventricular function at rest. In different patients the IHR was significantly related to each available index of left ventricular function. Other studies in animals have shown that the IHR is closely related to intrinsic myocardial contractility in certain forms of experimental heart failure. An analogous relationship existing between the IHR and myocardial function in patients with heart disease is suggested as the explanation for the IHR/ventricular function relationship in this study. If so, the IHR may prove valuable as an index of myocardial function in man, since it can be measured simply and safely in clinical practice.

Atropine↗
PubMed1999

Detection of the cardiac function by fractal dimension analysis.

Nonlinearity in circulation control attracts attention because nonlinearity is thought to be essential in the function of the living body. Many investigators have pointed out that the analysis of heart rate variability in particular is important in the analysis of autonomic nerve and cardiac function evaluation. Heart rate variability shows nonlinear behavior. However, until the present, many reports have been premised on linearity; linear correlation by frequency analysis has been used by many studies. However, in terms of this methodology, there is a problem applying it to the nonlinear living body. Therefore, fractal and chaos methodology has been used. The ascertainment of cardiac function has become important in allowing the clinical stage of a ventricular assist system to be successful. The purpose of this study was cardiac function evaluation by a methodology that was premised on nonlinearity. Chaos and fractal theory was used as a nonlinear dynamic theory. As a methodology of measurement, the volume of the left ventricle was used rather than an electrocardiogram, the waveform of arterial blood pressure. The volume was measured using acoustic quantification (AQ) ultrasonic echocardiography. Using these methodologies, the time series of many patients were analyzed. For example, drug administration was attempted in this study, and it was found that some drugs like ACE inhibitors showed a significant effect upon nonlinear dynamics in the cardiovascular system. The result, which attempted cardiac function evaluation by these various methodologies, is reported.

Angiotensin-Converting Enzyme Inhibitors↗
PubMed2006

Cardiac autonomic modulation during recovery from acute endurance versus resistance exercise.

BACKGROUND: The kinetics of parasympathetic reactivation after dynamic endurance exercise have been well elucidated. However, autonomic recovery of cardiac function after resistance exercise is not known. PURPOSE: The purpose of this study was to assess cardiac autonomic modulations during recovery from acute resistance exercise versus acute endurance exercise. METHODS: Electrocardiogram readings were collected before and 30 min after a single bout of endurance or resistance exercise in 14 male participants (aged 25.3+/-2.5 years). Heart rate (HR) variability was spectrally decomposed using an autoregressive approach. High frequency (HF) power was considered representative of vagal modulation. All values were expressed in both absolute and normalized units (normalized for change in total power). RESULTS: A mode-by-time interaction (P<0.05) was detected for HR, which remained elevated to a greater extent after resistance exercise. Total power was significantly reduced after resistance exercise (P<0.05) but not endurance exercise. An interaction (P<0.05) was also detected for both a change in absolute natural log function HF power and natural log function low frequency (LF) power (P<0.05), as both variables decreased more after resistance exercise. When normalized for changes in total power, interactions in LF and HF power were lost. The LF/HF ratio was significantly increased after both resistance and endurance exercise (P<0.05). CONCLUSION: Greater elevations in HR after acute resistance exercise versus acute endurance exercise may be related to greater reductions in cardiac parasympathetic tone.

Adult↗
PubMedDate not supplied

Distribution of cardiac nerves in patients with diabetes mellitus: an immunohistochemical postmortem study of human hearts.

BACKGROUND: Autonomic neuropathy and functional cardiac denervation are complications of diabetes mellitus (DM). It is unknown if DM patients show histopathologic evidence of cardiac denervation. METHODS AND RESULTS: Nine sites were sampled at fixed distances from the atrioventricular valves from 27 postmortem hearts. Sections were stained with antibodies to S100 protein and to neurofilament (NF). Samples were visualized by light microscopy using the avidin-biotin peroxidase technique. The amount of cardiac nerves was graded blindly using semiquantitative methods according to the following criteria: Grade 0=presence of nerves in the epicardium only; Grade 1=strictly perivascular nerves; Grade 2=Grade 1 and nerve sprouts between myocardial cells sporadically; Grade 3=Grade 2 and nerve sprouts throughout the myocardium and endocardium. Specimens were divided into four groups. Control group consisted of patients with neither myocardial infarction (MI) nor DM. Experimental groups consisted of MI (n=7), MI with DM (n=6), and DM without MI (n=8). Average age of all patients was 57.3+/-15.7 years. No age differences existed among groups. Heterogeneous nerve distribution existed in all groups. S100-positive nerve density for control, MI, DM and MI, and DM without MI are 1.95+/-0.40, 1.66+/-0.54, 1.54+/-0.37, and 1.81+/-0.14, respectively (P=ns). NF-positive nerve density in the same groups were 1.10+/-0.18, 1.31+/-0.24, 1.13+/-0.12, and 1.19+/-0.42, respectively (P=ns). No differences in nerve densities between anterior and inferoposterior sections of the left ventricle existed. CONCLUSION: In postmortem human hearts, cardiac nerve distribution was heterogeneous among normal, MI, and DM patients. No evidence of cardiac denervation in patients with DM was demonstrated.

Autonomic Nervous System↗
PubMed2002

Complexities in ETS-domain transcription factor function and regulation: lessons from the TCF (ternary complex factor) subfamily. The Colworth Medal Lecture.

The ETS-domain transcription factor family can be divided into a series of subfamilies. Elk-1 represents the founding member of the ternary complex factor (TCF) subfamily. By focusing on the TCF subfamily, we can demonstrate the complexities that exist in the function and regulation of ETS-domain transcription factors. This article focuses on Elk-1 in detail and summarizes the functions of other TCFs. The key themes covered include the domain structure of the TCFs, the mechanisms of complex formation with serum response factor, regulation of TCFs by mitogen-activated protein kinase cascades, and transcriptional regulatory properties of the TCFs. Finally, the emerging role of the TCFs in vivo is discussed. A picture is developing indicating that, while these proteins exhibit significant sequence and functional conservation, key differences in their structure and regulation are being identified which may relate to unique functions of these proteins in vivo.

Amino Acid Sequence↗
PubMed1988

Somatic and autonomic nerve function during the first year after diagnosis of type 1 (insulin-dependent) diabetes.

Somatic and autonomic nerve function was assessed by motor and sensory nerve conduction velocities (MNCV; SNCV), beat-to-beat variation at rest, speed of pupillary dilation, and pupillary latency time in 35 newly diagnosed type 1 diabetic patients aged 12-36 years. The nerve function tests were performed 18 +/- 2 (mean +/- SEM) days after the correction of initial ketosis and hyperglycaemia and again after 3 and 12 months of insulin therapy. Mean HbA1 levels of months 3 and 12 within the normal range less than 8.6% (mean: 7.2 +/- 0.2%) were observed in 24 patients (group 1) and greater than or equal to 8.6% (mean: 10.1 +/- 0.6%) in 11 patients (group 2). Group 1 showed no significant changes from baseline in the mean nerve conduction and autonomic functions after 3 and 12 months. In group 2 there was no change until three months, however, at 12 months there was a significant decrease in mean MNCV in the median, ulnar and peroneal nerves (p less than 0.05) and in mean SNCV in the median (p less than 0.05) and sural nerves (p less than 0.01), when compared to the baseline values. The autonomic function tests remained unchanged. No patient had symptoms of neuropathy during the period studied. These findings suggest that the deterioration of motor and sensory nerve conduction precedes that of cardiac and pupillary autonomic function in poorly controlled asymptomatic type 1 diabetic patients during the first year of the disease. Effective glycaemic control prevented progression of subclinical neuropathy, but did not reverse abnormalities which were present at diagnosis.

Adolescent↗
PubMed2001

Heart rate variability in childhood obesity.

UNLABELLED: Obesity is characterized by hemodynamic and metabolic alterations. Autonomic control on cardiac function involvement is controversial. The aim of the study was to assess early sign of cardiac autonomic dysfunction in obesity, using time- and frequency-domain heart rate variability (HRV) analysis in a pediatric population. METHODS: 32 obese children (OB) (17 M, 15 F; 13.9 +/- 1.7 y) were compared with 13 healthy lean subjects (7 M, 6 F; 12.9 +/- 1.6 y). For each participant, the authors performed a clinical examination, laboratory testing, blood pressure (BP) measurements, and 24-hour electrocardiograph/ambulatory BP monitoring. The spectral power was quantified in total power, low-frequency (LF) power, index of sympathetic tone, high-frequency (HF) power, index of vagal tone, and LF/HF ratio. Low frequency and HF were averaged to obtain 3 measures: 24-hour, daytime, and nighttime levels. Total, long-term, and short-term time-domain HRV values were calculated. RESULTS: The obese children had higher casual and ambulatory BP, and higher fasting glucose, insulin, and triglyceride levels. Overall HRV values were not significantly lower in OB. The obese children had significantly lower 24-hour and nighttime high-frequency normalized units, and time-domain measures of vagal activity. Low-frequency power showed an inverse but not significant pattern. The OB group had significantly greater 24-hour and nighttime LF/HF ratios. CONCLUSIONS: The authors found an increase in heart rate and in BP associated with parasympathetic heart rate control decrease in stabilized obese normotensive children.

Adolescent↗
PubMed1995

Effects of acutely raising intracranial pressure on cardiac sympathetic efferent neuron function.

OBJECTIVE: To determine whether acutely raising intracranial pressure modifies the function of cardiac efferent autonomic neurons. METHODS: The effects of suddenly raising intracranial pressure above systemic vascular pressure on heart rate, left atrial and left ventricular chamber pressures, as well as right and left ventricular intramyocardial pressures, were studied following removal of the adrenal glands from the circulation. Cardiac effects induced by systemic administration of nicotine, tyramine or isoproterenol were investigated before and after raising intracranial pressure: (1) in 9 dogs with neurally intact hearts in which cardiac release of catecholamines and intrinsic cardiac neuronal activity were studied; (2) in another 8 dogs in which intrathoracic autonomic neurons were disconnected from central neurons; (3) in another 8 dogs after decentralizing intrathoracic sympathetic but not parasympathetic neurons; (4) in 2 animals after decentralizing intrathoracic parasympathetic, not sympathetic neurons. RESULTS: Increasing intracranial pressure in neurally intact preparations induced ventricular augmentation followed by depression such that after 12 min of cerebral ischemia left ventricular systolic pressure was 62 +/- 5 mmHg. Isoproterenol and tyramine augmented right ventricular inotropism similarly before and after raising intracranial pressure, their effects on left ventricular systolic pressures being reduced secondary to the systemic vascular hypotension. Although nicotine excited intrinsic cardiac neurons similarly before and after raising intracranial pressure, it failed to enhance cardiac liberation of noradrenaline after compared to before raising intracranial pressure. Nicotine-induced ventricular augmentation was obtunded after brain death despite the fact that ventricular myocytes underwent no detectable histological changes. In contrast, nicotine induced similar cardiac augmentation before and after raising intracranial pressure when intrathoracic autonomic neurons or when intrathoracic sympathetic, not parasympathetic neurons, were decentralized. CONCLUSION: Cardiac sympathetic efferent neuronal function is obtained by acutely raising intracranial pressure.

Adrenalectomy↗
PubMed1996

Changes in cardiocirculatory autonomic function after thoracoscopic upper dorsal sympathicolysis for essential hyperhidrosis.

Essential hyperhidrosis (EH) is caused by an unexplained overactivity of the sympathetic fibers which pass through the upper dorsal sympathetic ganglia D2 and D3. Since the D2 and D3 ganglia are also involved in the sympathetic cardiac innervation, cardiocirculatory autonomic function may also be abnormal in EH. In order to study the function of the sympathetic nervous system in EH, and to assess the effects of thoracoscopic sympathiocolysis, cardiocirculatory autonomic function tests were performed in 13 consecutive patients with EH, before (baseline) and 6 weeks after the thoracoscopic intervention. Baseline data were also compared with data obtained from 13 matched healthy volunteers: EH patients showed an increased heart rate at rest, but only in the standing position (94 +/- 18.5 vs 78 +/- 10.9 bpm, P < 0.01), as well as an increased ratio of low to high frequency power of the heart rate variability in the standing position (5.92 +/- 4.4 vs 2.8 +/- 2.5, P < 0.05). Exercise tests were normal in every EH patient. After sympathiocolysis, heart rate at rest (sitting on the cycloergometer) had decreased (75.4 +/- 13 vs 90.4 +/- 16.5 bpm, P < 0.05), as well as heart rate at maximal exercise (165.2 +/- 14.8 vs 180 +/- 10 bpm, P < 0.05). Exercise capacity and the cardiorespiratory responses to exercise were, however, unchanged after sympathicolysis. Resting heart rate in the lying (66 +/- 10 vs 76 +/- 15 bpm, P < 0.05) and standing positions (82 +/- 13.8 vs 94 +/- 18.5 bpm, P < 0.05), and the diastolic blood pressure reaction to a handgrip test (73.6 +/- 8.6 vs 84.7 +/- 11.6 mmHg, P < 0.05) were also lowered after sympathicolysis. In conclusion, patients with EH show an overfunctioning of the sympathetic system which is characterised by an increased reaction to stress (standing, exercise), whereas resting sympathetic tone is unaffected. Thoracoscopic D2-D3 sympathicolysis corrects this hyperfunction and has a partial beta-blocker-like activity, which results in a decrease in heart rate at rest and during maximal exercise, and in the diastolic blood pressure response to the handgrip test. Further studies are needed to assess the long-term consequences of this procedure.

Adolescent↗
PubMed2004

Effects of shift work on autonomic and neuromotor functions in female nurses.

Thirty-seven nurses with shift work, working under a rotating three-shift system, and 37 nurses without shift work, having worked during the daytime for one or more years prior to this study, were examined to assess the effects of shift work on cardiac autonomic and neuromotor functions. Their ages ranged from 25 to 58 yr. The electrocardiographic (ECG) R-R interval variability, %LF and %HF (i.e., proportions of sympathetic and parasympathetic activities, respectively), and LF/HF ratio were computed by means of autoregressive spectral and component analyses. The %LF and LF/HF ratio were significantly larger in the nurses with shift work than in those without shift work, although there was no significant difference in the heart rate-corrected QT interval on ECG between them. And, hand-ear coordination differed significantly between the nurses with shift work and those without. Despite the presence of potential selection bias, it is suggested that shift work in nurses may cause not only a long-term sympathodominant state but also some neuromotor impairment.

Adult↗
PubMed2005

Are cardiac syndrome X, irritable bowel syndrome and reflex sympathetic dystrophy examples of lateral medullary ischaemic syndromes?

Altered pain appreciation and autonomic function are hallmarks of Cardiac syndrome X, Irritable bowel syndrome and Reflex sympathetic dystrophy. Both pain appreciation and autonomic function are controlled by the lateral medulla. This hypothesis proposes that lateral medullary ischaemia at a microvascular level is responsible for these syndromes and could also be linked to other conditions where autonomic dysfunction is a major feature such as late-onset asthma, type 2 diabetes and essential hypertension. Autonomic function is controlled by the nucleus tractus solitarius, which acts as the main viscero-afferent nucleus in the brain stem regulating vagal tone. It is particularly susceptible to ischaemia since it is highly metabolically active and lies in a medullary arterial watershed zone. The anatomical route of the vertebral artery through cervical vertebra makes it vulnerable to injury from whiplash with or without any genetic predisposition to atheroma formation. This could make microvascular occlusion commonplace and a plausible explanation for the above syndromes. Ischaemia rather than infarction occurs because of the excellent collateral blood supply in the brainstem. In support of this hypothesis, a new Transcranial doppler ultrasonography arterial signal has been described called small vessel knock, the ultrasound signal of small vessel occlusion. Recent evidence has shown that ultrasound targeting of this signal in the vertebral artery improves clinical symptoms in these syndromes which supports this hypothesis. Two such cases are discussed.

Arterial Occlusive Diseases↗
PubMed2002

[Neurophysiological investigations in patients with sleep apnoea syndrome].

UNLABELLED: The untreated sleep apnoea syndrome (SAS) is associated with cardiovascular complications (arterial hypertension, coronary heart disease, cardiac arrhythmia) and increased morbidity and mortality. Disorders of the autonomic nervous system function are probably responsible for cardiac arrhythmia. Most researchers evaluated autonomic function using cardiovascular tests. The aim of our study was to assess whether neurophysiological method--sympathetic skin response (SSR)--could be useful in testing function of the autonomic nervous system in patients with SAS. MATERIAL AND METHODS: The examined group consisted of 26 patients with SAS recognised by polysomnography (mean apnoea index: 42 +/- 31, mean age: 52 +/- 9 years). The control group consisted of 27 healthy volunteers (mean age: 50.5 +/- 3 years). SSR was recorded simultaneously from the right palm and right foot. Latencies and amplitudes of SSR were measured. Recordings were carried out using an electromyograph (Counterpoint). Statistical analysis was performed using student's t-test. RESULTS: We could not obtain SSR in 10 patients with SAS (38.5%). In the remaining patients the SSR amplitudes in the upper limb were significantly lower (250.6 +/- 131 uV) than in the control group (582.8 +/- 76.7 uV) (p < 0.001). The SSR amplitudes in the lower limb were also decreased (128.1 +/- 77 uV), but not significantly, in comparison to control group (156.9 +/- 28.3 uV). We did not observe changes in latencies between the groups. CONCLUSIONS: Results of our study provide evidence for autonomic disorders in patients with SAS. Sympathetic skin response (SSR) is a simple and fast neurophysiological method useful in testing function of the autonomic nervous system in patients with SAS.

Adult↗
PubMed2005

Epidermal growth factor A61G polymorphism and cardiac autonomic control in adults.

The authors examined the relationship between functional epidermal growth factor gene A61G polymorphism and cardiac autonomic control in a sample of 75 young adults. Heart rate, preejection period, and respiratory sinus arrhythmia were measured continuously during rest and a set of challenging tasks. The functional G allele of the epidermal growth factor gene was associated with lower heart rate F(5,32), 6.92, p = 0.014, eta2 = 0.19, and higher respiratory sinus arrhythmia F(5,32), 4.71, p = 0.038, eta2 = 0.14, among women during the rest, but was not related to with cardiovascular reactivity for challenges in women or in men. The present findings suggest that epidermal growth factor A61G polymorphism is associated with cardiac control in women.

Acoustic Stimulation↗
PubMed2006

Autonomic nervous system control of the cardiovascular and respiratory systems in asthma.

Patients with asthma have exaggerated bronchoconstriction of their airways in response to certain indirect (e.g. cold air, allergens, dust, exercise) or direct (e.g. inhaled methacholine) stimuli. This 'hyper-reactivity' usually co-exists with airway inflammation, although the pathophysiological mechanisms underlying these changes are not fully understood. It is likely that this hyper-reactivity is associated with abnormal autonomic nervous system (ANS) control. In particular, the parasympathetic (vagal) component of the ANS appears to be implicated in the pathogenesis of asthma. In addition, several studies have suggested the existence of differential alteration in ANS function following exercise in asthmatics compared with non-asthmatic individuals. Several early studies suggested that the altered autonomic control of airway calibre in asthma might be reflected by a parallel change in heart rate. Cardiac vagal reactivity does indeed appear to be increased in asthma, as demonstrated by the cardiac response to various autonomic functions tests. However, other studies have reported a lack of association between bronchial and cardiac vagal tone, and this is in accord with the concept of system-independent ANS control. This review provides a discussion of cardiovascular-autonomic changes associated with either the pathophysiology of asthma per se or with asthma pharmacotherapy treatment. Previous investigations are summarised suggesting an apparent association between altered autonomic-cardiovascular control and bronchial asthma. The full extent of autonomic dysfunction, and its clinical implications, has yet to be fully determined and should be the subject of future investigation.

Adrenergic beta-Agonists↗
PubMed2004

Assessment of cardiac autonomic regulation in children with monosymptomatic nocturnal enuresis by analysis of heart rate variability.

The pathogenesis of monosymptomatic nocturnal enuresis is controversial. Various urodynamic studies showed bladder hyperactivity in enuretic children. But the exact cause is not precisely known. The aim of this study was to understand whether the autonomic nervous system dysfunction is involved in this bladder hyperactivity or not. Heart rate variability measurement is widely used for evaluation of cardiac autonomic activity. We evaluated cardiac autonomic nervous system functions in monosymptomatic nocturnal enuretic children by using 24-hour Holter electrocardiogram. The study group consisted of 32 enuretic children (20 boys and 12 girls) and the control group consisted of 20 healthy children (12 boys and 8 girls). In these two groups, we assessed cardiac autonomic regulation by analysis of heart rate variability, and found a significantly higher parasympathetic activity in enuretic children than controls. We suggest that the parasympathetic nervous system hyperactivity plays a role in nocturnal enuresis by causing vesical hyperactivity in monosymptomatic enuretic children.

Autonomic Nervous System↗