Cardiovagal modulation in pediatric functional gastrointestinal disorders

Area of Science:

• Cardiology
• Gastroenterology
• Pediatrics

Background:

• Reduced cardiovagal modulation is known in adults with Irritable Bowel Syndrome (IBS).
• Cardiovagal modulation in adolescents with functional gastrointestinal disorders (FGID) has not been previously studied.
• Investigating cardiovagal modulation in adolescents with FGID is crucial for understanding pediatric FGID pathophysiology.

Purpose of the Study:

• To investigate cardiovagal modulation in adolescents diagnosed with FGID.
• To compare cardiovagal modulation between FGID adolescents and a healthy control group.
• To determine if FGID in adolescents is associated with altered heart rate variability (HRV).

Main Methods:

• Electrocardiogram (ECG) recordings were taken from healthy and FGID adolescents in supine and standing positions.
• Heart rate variability (HRV) analysis, including high-frequency (hf) and low-frequency (lf) components, was performed using Kubios 2.2 software.
• Statistical analysis involved Wilcoxon signed-ranks, Kruskal-Wallis, and Mann-Whitney U tests to compare HRV data within and between groups.

Main Results:

• Adolescents with FGID (n=50) and healthy controls (HC, n=22) participated; 90% of FGID subjects were female (median age 17).
• Both groups showed higher absolute and relative supine high-frequency HRV (hfHRV) compared to standing.
• FGID patients had higher absolute supine low-frequency HRV (lfHRV) than standing, unlike HCs. FGID group exhibited significantly lower absolute HRV compared to HC.

Conclusions:

• Cardiovagal modulation is demonstrably lower in adolescents experiencing FGID.
• This reduced cardiovagal modulation significantly impacts adolescents with FGID.
• The causal relationship between reduced cardiovagal modulation and FGID in adolescents remains undetermined.