M. Barczynski et P. Thor, Reversible autonomic dysfunction in hyperthyroid patients affects gastric myoelectrical activity and emptying, CLIN AUTON, 11(4), 2001, pp. 243-249
The autonomic nervous system (ANS) function in hyperthyroidism has been so
far investigated mainly from the cardiovascular point of view. The aim of t
his study is to show that the ANS dysfunction in hyperthyroidism is also ex
pressed in gastric myoelectrical activity disturbances and gastric emptying
disorders and to search for a correlation between the severity of clinical
manifestation and free thyroid hormone levels and the degree of the ANS dy
sfunction. The analyzed group included 50 recently diagnosed patients with
hyperthyroidism who were examined twice: before and after 3 months of thyro
static treatment. Results were compared with those of a sex-, age- and BMI-
matched control group of 50 healthy volunteers. The study included: heart r
ate variability analysis in time and frequency domain, at rest and during a
deep-breathing test, surface electrogastrography in preprandial and postpr
andial periods measured simultaneously with the ultrasound assessment of ga
stric emptying time by Bolondi method. In patients with hyperthyroidism in
comparison with the control group, the following significant differences we
re observed: a sharp reduction of the high-frequency component and a decrea
se of heart rate variability, a high incidence of dysrhythmia with dominant
bradyarrhythmia, and a delay of gastric emptying. The degree of disorders
related to the degree of clinical manifestation of hyperthyroidism's sympto
ms and free triiodothyronine serum concentration both. All the disorders we
re functional and disappeared in a stable euthyroidism. To conclude, the AN
S dysfunction in hyperthyroidism results not only in withdrawal of vagal in
hibitory effect on sinoatrial node, but in impaired mutual neuro-hormonal r
egulation (decrease of vagal influence) of gastric myoelectrical activity f
ollowed by delay of gastric emptying.