Gastroenterology Research, ISSN 1918-2805 print, 1918-2813 online, Open Access
Article copyright, the authors; Journal compilation copyright, Gastroenterol Res and Elmer Press Inc
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Original Article

Volume 9, Number 1, February 2016, pages 10-16

Autonomic Evaluation of Patients With Gastroparesis and Neurostimulation: Comparisons of Direct/Systemic and Indirect/Cardiac Measures


Figure 1.
Figure 1. Symptoms, autonomic and enteric measures at baseline and 1 year after gastric stimulation at center one. EGG: electrogastrography; Gp: gastroparesis; SAF: sympathetic adrenergic function; VCF: vagal cholinergic function.
Figure 2.
Figure 2. Symptoms and heart rate variability measures in patients undergoing gastric electrical stimulation at center two. LF: adrenergic/low-frequency; HF: cholinergic/high-frequency.
Figure 3.
Figure 3. Comparison of autonomic function testing and heart rate variability in five patients with diabetic gastroparesis at baseline at center three. VCF: vagal cholinergic function; RR: R-to-R interval; VR: Valsalva ratio; SAF: sympathetic adrenergic function; VC: vasoconstriction; PAR: postural adjustment ratio; EGG: electrogastrography; LF: adrenergic/low-frequency; HF: cholinergic/high-frequency; HRV: heart rate variability.


Table 1. Autonomic and Enteric Measures at Baseline and 1 Year Post-Gastric Electrical Stimulation at Center One
Group 1: 39 patientsBaselineFollow-upP-value
Gastroparesis (Gp) symptoms40.5 ± 1.825.4 ± 2.9< 0.001
Cardio-vagal function (VCF)21.9 ± 2.326.2 ± 3.40.15
Sympathetic-adrenergic function (SAF)104.7 ± 5.782.9 ± 8.4< 0.05
Electrogastrography (EGG)3.8 ± 0.2 cpm3.6 ± 0.1 cpm0.3


Table 2. Symptoms and Heart Rate Variability in Patients Undergoing Gastric Electrical Stimulation at Center Two
Group 2: 35 patientsBaselineFollow-upP-value
Symptoms39.0 ± 1.919.9 ± 3.7< 0.001
Low to high frequency ratio1.4 ± 0.11.1 ± 0.070.1


Table 3. Comparison of Heart Rate Variability and Autonomic Nervous System With Electrogastrogram Values in a Pilot Study of Five Patients at Center Three
SubjectHRV %Δ LF/HF with mealHRV interpretationSAF %VCSAF PARTotal SAF = VC + PARTotal VCF = RR + VR + 30/15AFT interpretationEGG %Δ in frequency with meal
AFT: autonomic nervous system testing; EGG: electrogastrography; Gp: gastroparesis; HF: cholinergic/high frequency; HRV: heart rate variability; LF: adrenergic/low-frequency; SAF: sympathetic adrenergic function; VCF: vagal cholinergic function.
133.33Sympathetic dominant923.395.3020.23Normal parasympathetic/abnormal sympathetic (PAR)-24.10
221.57Sympathetic dominant792.281.2014.28Abnormal sympathetic (PAR)79.86
3-22.47Parasympathetic dominantNA11NA26.41Abnormal sympathetic (PAR)-26.37
4-42.62Parasympathetic dominant84.53.588.009.13Abnormal parasympathetic > abnormal sympathetic (PAR)-18.37
592.00Sympathetic dominant9814112.0020.61Normal parasympathetic/abnormal sympathetic (PAR)-27.88