Association between heart rate variability and inflammatory bowel disease activity: a prospective cohort study.

INTRODUCTION

The autonomic nervous system (ANS), particularly its parasympathetic branch, appears to play a role in the regulation of inflammatory pathways in inflammatory bowel diseases (IBD). Heart rate variability (HRV) is one of the methods used to assess ANS activity.

AIM: The aim of the study was to determine whether HRV monitoring can be used to assess the activity of inflammatory bowel diseases (IBD) or predict the response to treatment.

MATERIAL AND

METHODS

We evaluated HRV parameters in 26 patients, 19 with Crohn's disease (CD) and 7 with ulcerative colitis (UC). Holter electrocardiogram (Holter ECG) monitoring was performed three times: first at the time of disease exacerbation and study inclusion, second after achieving clinical improvement, and third during clinical remission.

RESULTS

The high-frequency spectrum (HF) parameter averaged 29.392 ±8.524 Hz in disease exacerbation, while in remission it decreased to an average of 25.803 ±5.062 Hz. We also observed an association between the percentage change in root mean square of successive differences (RMSSD) and the proportion of successive NN intervals that differ by more than 50 ms (pNN50) between measurements taken during exacerbation and remission with the time to the next disease exacerbation.

CONCLUSIONS

It was additionally found that higher baseline standard deviation of the NN interval (SDNN) values associated with a longer period of remission. The limitations of our study preclude the formulation of definitive conclusions. However, HRV assessment and vagus nerve stimulation may still represent promising avenues for future research.