Is autonomic dysfunction a necessary condition for chronic peptic ulcer formation?

Background: The relationship between 1/f fluctuation of the heart rate vari ability and Helicobacter pylori infection was evaluated, in order to clarif y whether autonomic nervous dysfunction is a necessary condition for chroni c peptic ulcer formation. Methods: The subjects were 11 patients with recurrent chronic peptic ulcer and 20 age-matched normal subjects. Holter ECGs were recorded over 24h, and the 1/f(-x) fluctuation of the heart rate was computed. The 1/f(-x) fluctu ation of the heart rate is a novel index of autonomic function that has bee n shown to reflect a patient's pleasant mood. For 1/f(-x) fluctuation, the slope of the regression line (-x) was determined and cosine fitting of the absolute slope of the regression line over a 24-h period was performed. Results: For the normal group, the absolute slope of the regression line du ring daytime and night-time were 0.53+/-0.16 and 1.05+/-0.18, respectively. For the peptic ulcer group, the corresponding values during daytime and ni ght-time were 0.94+/-0.15 and 1.84+/-0.18, respectively. The mean value of the cosine curve was 0.76+/-0.23 in the normal group and 1.12+/-0.25 in the peptic ulcer group. Thus, these values were significantly higher for the l atter group than for the former group (P<0.05). No statistically significan t difference in H. pylori infection between the two groups was observed. Conclusions: Autonomic nervous dysfunction as well as H. pylori infection a ppears to be a necessary condition for chronic peptic ulcer formation.