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We evaluated ANS function following postural changes in patients with PE.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The participants were 14 healthy men (control group) and 20 men with PE (study group). Psychological function was assessed using the visual analog scale for pain, Brief Symptom Rating Scale-5, and Beck Depression Inventory-II. Sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI). ANS regulation in response to postural change was measured in the supine position and immediately after sitting. All measurements were compared between the control and study groups at baseline and between the study groups before and after Nuss surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>At baseline, upon postural change, symptomatic activity increased in the control group (50.3\u201367.4%, p\u2009=\u20090.035) but not in the study group (55.0\u201354.9%, p\u2009=\u20090.654); parasympathetic activity decreased in the control group (49.7\u201332.6%, p\u2009=\u20090.035) but not in the study group (45.1\u201345.1%, p\u2009=\u20090.654); and overall ANS regulation increased in the control group (1.02\u20132.08, p\u2009=\u20090.030) but not in the study group (1.22\u20131.22, p\u2009=\u20090.322). In response to postural change after Nuss surgery in the study group, sympathetic activity increased (48.7\u201370.2%, p\u2009=\u20090.005), parasympathetic activity decreased (51.3\u201329.8%, p\u2009=\u20090.005), and overall ANS regulation increased (0.95\u20132.36, p\u2009=\u20090.012).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>ANS function in response to postural change is dysregulated in patients with PE, which improved after Nuss surgery.<\/jats:p><jats:p><jats:italic>Trial registration<\/jats:italic>ClinicalTrials.gov, ID: NCT03346876, November 15, 2017, retrospectively registered,<jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/register.clinicaltrials.gov\/prs\/app\/action\/SelectProtocol?sid=S0007KGI&amp;selectaction=Edit&amp;uid=U0003JZU&amp;ts=2&amp;cx=cstxeg\">https:\/\/register.clinicaltrials.gov\/prs\/app\/action\/SelectProtocol?sid=S0007KGI&amp;selectaction=Edit&amp;uid=U0003JZU&amp;ts=2&amp;cx=cstxeg<\/jats:ext-link><\/jats:p><\/jats:sec>","DOI":"10.1186\/s13019-022-01835-5","type":"journal-article","created":{"date-parts":[[2022,5,3]],"date-time":"2022-05-03T12:03:12Z","timestamp":1651579392000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Autonomic nervous system dysregulation in response to postural change in patients with pectus excavatum in Taiwan: a pilot study"],"prefix":"10.1186","volume":"17","clinical-trial-number":[{"clinical-trial-number":"nct03346876","registry":"10.18810\/clinical-trials-gov"}],"author":[{"given":"Yu-Ting","family":"Hsu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yeung-Leung","family":"Cheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi-Wei","family":"Chang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chou-Chin","family":"Lan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yao-Kuang","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6503-5189","authenticated-orcid":false,"given":"Mei-Chen","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,5,3]]},"reference":[{"key":"1835_CR1","unstructured":"Heart rate variability. 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The Institutional Review Board of Taipei Tzu Chi Hospital had approved this study (Protocol No.: 05-XD57-110). Informed consent was obtained from all individual participants included in the study.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Consent for publication was obtained from all the participants.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"89"}}