Abstract
Objective To explore the autonomic nerve rhythm and the correlation between palpitations below the heart (PBTH) and autonomic nerve function in patients with PBTH based on heart rate variability (HRV). Methods The outpatients or ward patients of Wenzhou Hospital of Traditional Chinese Medicine were collected and divided into two groups: the PBTH group and the normal group. The HRV of each group was detected. Single-factor statistical methods, Spearman correlation analysis, and logistic regression were used to describe and analyze the rhythm and characteristics of autonomic nerves in patients with PBTH and the correlation between PBTH and autonomic nerve function. Results (1) In the comparison of HRV in different time periods in the same group, the SDNN, RMSSD, pNN50, TP, and HF in the PBTH group at night were significantly higher than those in the daytime (P < 0.01), while the LF/HF ratio was significantly lower than that in the daytime (P < 0.01). (2) In the comparison of HRV between the two groups in the same time period, the RMSSD and pNN50 of the PBTH group during the daytime period were significantly higher than those of the normal control group (P < 0.05), and the LF/HF was significantly lower than that of the normal group (P < 0.05). (3) In the Spearman correlation analysis, PBTH was significantly correlated with RMSSD, pNN50, and LF/HF ratio in the daytime period, with correlation coefficients of 0.424, 0.462, and −0.524, respectively (P < 0.05). (4) Logistic regression analysis showed that the decrease of LF/HF ratio during the daytime period was an independent risk factor for PBTH in TCM (OR = 0.474, 95% CI: 0.230–0.977, P < 0.05). Conclusions The changes in parasympathetic nerve function in patients with PBTH have a circadian rhythm, which is characterized by increased activity during the nighttime. At the same time, the autonomic nerve activity of people with PBTH during the daytime is unbalanced, and the decrease of LF/HF ratio during the day is an independent high risk factor for PBTH.
Highlights
Palpitations below the heart (PBTH) is a common clinical syndrome characterized by “conscious subcardiac epigastric beating,” “throbbing at the lower part of the heart,” and “palpitation rhythm consistent with the pulse and obvious pulse in the heart area,” accounting for about 14% of all clinical abdominal syndromes [1], which seriously affect the quality of life of patients
Were compared between the two groups to reflect the difference in autonomic nervous function between the PBTH group and normal control group. e results showed that the SDNN, RMSSD, SDANN, and HF indexes of the PBTH group had a tendency to increase compared with the normal control group, and the total power (TP), LF, and low frequency to high frequency (LF/HF) indexes had a downward trend compared with the normal group, but the difference between the two groups was not statistically significant (P > 0.05)
It is suggested that the autonomic nervous activity of normal people is in different regulation state in the daytime and at night. e sympathetic and parasympathetic nerve activities increase in varying degrees at night, especially parasympathetic nerve activity
Summary
Palpitations below the heart (PBTH) is a common clinical syndrome characterized by “conscious subcardiac epigastric beating,” “throbbing at the lower part of the heart,” and “palpitation rhythm consistent with the pulse and obvious pulse in the heart area,” accounting for about 14% of all clinical abdominal syndromes [1], which seriously affect the quality of life of patients. Even though our team has initially established the corresponding standard of PBTH in TCM based on the Delphi method in the early stages [2], there are few further objective studies concerning PBTH all over the world, and the research on its internal related factors and mechanism has not been carried out yet, so there is no obvious progress in the treatment of it in medicine. Based on the previous analysis of the ancient literature, clinical symptoms, similar research, and pharmacology of effective drugs, we preliminarily believe that there may be a certain relationship between PBTH and autonomic nerve function [3]. Erefore, we put forward the scientific hypothesis that PBTH is closely related to autonomic nerve function and designed objective scientific research to reveal it Similar studies of PBTH in other parts, indicate that PBTH is more likely to be related to autonomic nervous imbalance [8]. erefore, we put forward the scientific hypothesis that PBTH is closely related to autonomic nerve function and designed objective scientific research to reveal it
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