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DOI: 10.1055/s-0029-1243627
© Georg Thieme Verlag KG Stuttgart · New York
Heart Rate Variability Analysis Reveals a Shift in Autonomic Balance Towards an Increase in Parasympathetic Tonus in Boys with Undescended Testis
Publikationsverlauf
                     received July 10, 2009
                     
                     accepted after revision November 14, 2009
                     
Publikationsdatum:
18. Januar 2010 (online)

Abstract
Aim: Evaluations of sacs and cremaster muscles associated with undescended testis (UT) have revealed a decrease in sympathetic, but an increase in parasympathetic tonuses. Since the low frequency/high frequency power ratio obtained through spectral analysis of heart rate variability (HRV) determines the sympatho-parasympathetic balance, the sympatho-parasympathetic balance as defined by HRV in healthy boys and in boys with UT were compared.
Material and methods: Sixteen healthy boys and 21 boys with UT presenting as an isolated anomaly were evaluated. Powers in low and high frequency bands were determined by spectral analysis, and low frequency/high frequency ratios were calculated. Data were compared by analysis of variance, and p-values less than 0.05 were considered significant.
Results: Age distribution in the groups was similar. Low frequency/high frequency ratios were 2.27±1.84 and 1.26±0.79 in healthy boys and in boys with UT, respectively (p=0.0087).
Conclusion: The autonomic balance is shifted with a decrease in sympathetic and an increase of parasympathetic tonus in boys with UT. This difference in signaling may help to understand the decrease in fertility, and the increase in the risk of malignancy in men with UT.
Key words
cryptorchidism - undescended testis - inguinal hernia - heart rate - variability - autonomic tonus
References
- 1 
            Demirci M, Sarıbaş O, Uluç K. et al .
            Carotid artery stenting and endarterectomy have different effects on heart rate variability. 
            J Neurol Sci. 
            2006; 
            241 
            45-51 
            
            Reference Ris Wihthout Link
- 2 Frohman L, Cameron J, Wise P. Neuroendocrine systems II: growth, reproduction, and lactation. In: Zigmond MJ, Bloom FE, Landis SC, Roberts JL, Squire Rl. 
            Fundamental Neuroscience . San Diego: Academic Press 1999: 1151-1187Reference Ris Wihthout Link
- 3 
            Gerendai I, Halász B. 
            Neuroendocrine asymmetry. 
            Front Neuroendocrinol. 
            1997; 
            18 
            354-381 
            
            Reference Ris Wihthout Link
- 4 
            Gendrel D, Roger M, Chaussain JL. et al .
            Correlation of pituitary and testicular responses to stimulation tests in cryptorchid
            children. 
            Acta Endocr. 
            1977; 
            86 
            641-650 
            
            Reference Ris Wihthout Link
- 5 
            Kleiger RE, Stein PK, Bigger JT Jr. 
            Heart rate variability: measurement and clinical utility. 
            ANE. 
            2005; 
            10 
            88-101 
            
            Reference Ris Wihthout Link
- 6 
            Malliani A. 
            Heart rate variability: from bench to bedside. 
            Eur J Intern Med. 
            2005; 
            16 
            12-20 
            
            Reference Ris Wihthout Link
- 7 
            Orer HS, Zhong S, Barman SM. et al .
            Central catecholaminergic neurons are involved in expression of the 10-Hz rhythm in
            SND. 
            Am J Physiol. 
            1996; 
            270 
            R333-R341 
            
            Reference Ris Wihthout Link
- 8 
            Park SK, Strouse DA, Selmanoff M. 
            Prolactin- and testosterone-induced inhibition of LH secretion after orchidectomy:
            role of catecholaminergic neurons terminating in the diagonal band of Broca, medial
            preoptic nucleus and median eminence. 
            J Endocrinol. 
            1996; 
            148 
            291-301 
            
            Reference Ris Wihthout Link
- 9 
            Rosa e Silva AA, Guimaraes MA, Lamano-Carvalho TL. et al .
            Chemical sympathectomy blocks androgen biosynthesis during prepuberty. 
            Braz J Med Biol Res. 
            1995; 
            28 
            1109-1112 
            
            Reference Ris Wihthout Link
- 10 
            Rosen RC, Kostis JB, Jekelis AW. 
            Beta-blocker effects on sexual function in normal males. 
            Arch Sex Behav. 
            1998; 
            17 
            241-255 
            
            Reference Ris Wihthout Link
- 11 
            Stauss HM. 
            Heart rate variability. 
            Am J Physiol Regul Integr Comp Physiol. 
            2003; 
            285 
            R927-R931 
            
            Reference Ris Wihthout Link
- 12 
            Sztajzel J. 
            Heart rate variability is a noninvasive electrocardiographic method to measure the
            autonomic nervous system. 
            Swiss Med Wkly. 
            2004; 
            134 
            514-522 
            
            Reference Ris Wihthout Link
- 13 
            Task Force of the European Society of Cardiology and the North American Society of
            Pacing and Electrophysiology .
            Heart rate variability: standards of measurement, physiological interpretation, and
            clinical use. 
            Circulation. 
            1996; 
            93 
            1043-1065 
            
            Reference Ris Wihthout Link
- 14 
            Tanyel FC. 
            The descent of testis and reason for failed descent. 
            Turk J Pediatr. 
            2004; 
            46 
            ((Suppl)) 
            7-17 
            
            Reference Ris Wihthout Link
- 15 
            Tanyel FC. 
            Obliteration of processus vaginalis: aberrations in the regulatory mechanism result
            in an inguinal hernia, hydrocele or undescended testis. 
            Turk J Pediatr. 
            2004; 
            46 
            ((Suppl)) 
            18-27 
            
            Reference Ris Wihthout Link
- 16 
            Tanyel FC, Sara Y, Ertunç M. et al .
            Lack of carbachol response indicates the absence of cholinergic receptors in sacs
            associated with undescended testis. 
            J Pediatr Surg. 
            1999; 
            34 
            1339-1344 
            
            Reference Ris Wihthout Link
- 17 
            Tanyel FC, Müftüoğlu S, Dağdeviren A. et al .
            Ultrastructural deficiency in autonomic innervation in cremasteric muscle of boys
            with undescended testis. 
            J Pediatr Surg. 
            2001; 
            36 
            573-578 
            
            Reference Ris Wihthout Link
- 18 
            Tanyel FC, Erdem S, Büyükpamukçu N. et al .
            Cremaster muscle is not sexually dimorphic, but that from boys with undescended testis
            reflects alterations related to autonomic innervation. 
            J Pediatr Surg. 
            2001; 
            36 
            877-880 
            
            Reference Ris Wihthout Link
- 19 
            Tanyel FC, Ertunç M, Büyükpamukçu N. et al .
            Mechanisms involved in contractile differences among cremaster muscles according to
            localization of testis. 
            J Pediatr Surg. 
            2001; 
            36 
            1551-1560 
            
            Reference Ris Wihthout Link
- 20 
            Tanyel FC, Talim B, Atilla P. et al .
            Myogenesis within the human gubernaculum: histological and immunohistological evaluation. 
            Eur J Pediatr Surg. 
            2005; 
            15 
            175-179 
            
            Reference Ris Wihthout Link
- 21 
            Tanyel FC, Yüzbaşıoğlu A, Kocaefe Ç. et al .
            Androgen receptor immunostaining and androgen receptor messenger ribonucleic acid
            expression are increased in cremaster muscles associated with undescended testis. 
            Urology. 
            2006; 
            67 
            855-858 
            
            Reference Ris Wihthout Link
- 22 
            Tomiyama H, Sasaki Y, Huynh J. et al .
            Testicular descent, cryptorchidism and inguinal hernia: the Melbourne perspective. 
            J Pediatr Urol. 
            2005; 
            1 
            11-25 
            
            Reference Ris Wihthout Link
Correspondence
Prof. Feridun Cahit Tanyel
         Hacettepe University Childrens Hospital
         
         Department of Pediatric Surgery Sihhiye
         
         06100 Ankara
         
         Turkey
         
         Telefon: +90 (0)312 31155 41
         
         Fax: +90 (0)312 31155 41
         
         eMail: ctanyel@hacettepe.edu.tr
         
         
 
     
      
    