Heart rate variability in gastroenterological diagnosis

A large number of patients with noncardiac chest pain are affected by conditions such as gastroesophageal reflux disease (GERD). Bernstein test (acid infusion into esophagus) has been used in patients with GERD for testing esophageal acid sensitivity. We tested the hypothesis that power spectra of heart rate variability may be altered in patients who are Bernstein test positive during esophageal acid infusion. In a group of 15 patients with GERD, there was a significant decrease in the LF:HF ratio (2.25±0.89 to 1.76±0.61, p<0.02) during the Bernstein test. Acid sensitive patients (11 out of 15) demonstrated higher resting LF:HF ratio. These results suggest that factors associated with resting sympathetic tone may in fact affect the perception of acid reflux