Bortolotti M, Sarti P, Brunelli F, Mazza M, Barbara L
1st Medical Clinic, University of Bologna, Italy.
Digestion. 1995;56(6):488-92. doi: 10.1159/000201281.
The aim of this study was to establish if patients with an esophageal dysmotility similar to that found in the majority of patients with 'swallow syncope' may also have a pathologic esophagocardiac reflex similar to that observed in these patients. The effects on heart rate induced by dry and solid swallows and by intraesophageal balloon distension were studied in 8 normal subjects and in 10 patients with diffuse esophageal spasm by simultaneous recording of ECG and intraesophageal pressures. Dry swallows induced a brief increase in heart rate, while deglutition of a solid bolus initially induced an increase followed by a decrease in heart rate, significantly more marked in patients with diffuse spasm. The intraesophageal balloon inflation induced a decrease in heart rate which was significantly more intense in patients with diffuse spasm. In conclusion, the esophageal wall distension either due to solid bolus ingestion or to balloon inflation elicits an inhibitory esophagocardiac reflex which is more intense in patients with diffuse spasm and might induce cardiac arrhythmias in predisposed subjects.
本研究的目的是确定食管动力障碍与大多数“吞咽性晕厥”患者相似的患者是否也存在与这些患者中观察到的类似的病理性食管心反射。通过同步记录心电图和食管内压力，研究了8名正常受试者和10名弥漫性食管痉挛患者吞咽干食和固体食物以及食管内气囊扩张对心率的影响。吞咽干食会使心率短暂增加，而吞咽固体食物团最初会使心率增加，随后降低，在弥漫性痉挛患者中这种变化更为明显。食管内气囊充气会使心率降低，在弥漫性痉挛患者中这种降低更为显著。总之，无论是由于摄入固体食物团还是气囊充气导致的食管壁扩张，都会引发抑制性食管心反射，在弥漫性痉挛患者中这种反射更为强烈，并且可能在易感个体中诱发心律失常。
