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Dantas FMNA, Magalhães PAF, Hora ECN, Andrade LB, Sarinho ESC. Heart rate variability in school-age children born moderate-to-late preterm. Early Hum Dev 2024; 189:105922. [PMID: 38163385 DOI: 10.1016/j.earlhumdev.2023.105922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 11/27/2023] [Accepted: 12/17/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND Prematurity is associated with reduced cardiac autonomic function. This study aimed to investigate the heart rate variability (HRV) in school-age children born moderately to late preterm (MLPT). METHODS This cross-sectional study investigated school-age children, aged 5 to 10 years, born moderate-to-late preterm. Electrocardiograms recordings were performed during fifteen-minutes. Time and frequency domain parameters were calculated, corrected for heart rate and compared between the groups. RESULTS A total of 123 children were evaluated and 119 were included in this study. HRV measures, studied in the time and frequency domains, were similar in both groups. Corrected values of root mean square of successive differences between normal cycles (RMSSD), percentage of successive cycles with a duration difference >50 ms (pNN50%), and high frequency (HF), indices that predominantly represent the parasympathetic activity of the autonomic nervous system, were 1.6E-7 and 1.8E-7 (p=0.226); 1.6E-13 and 1.6E-13 (p=0.506); 6.9E-12 and 7.4E-12 (p=0.968) in the preterm and control groups, respectively. CONCLUSION This study did not find differences in heart rate variability between school-age children born MLPT and those born at term, suggesting that plasticity of cardiac autonomic modulation continues to occur in children up to school age or there is less impairment of the autonomic system in MLPT.
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Affiliation(s)
- Fabianne M N A Dantas
- Research Group of Neonatal and Pediatric Physical Therapy, Baby GrUPE, Universidade de Pernambuco, Petrolina, Pernambuco, Brazil; Department of Physical Therapy, Universidade de Pernambuco, Pernambuco, Brazil.
| | - Paulo A F Magalhães
- Research Group of Neonatal and Pediatric Physical Therapy, Baby GrUPE, Universidade de Pernambuco, Petrolina, Pernambuco, Brazil; Department of Physical Therapy, Universidade de Pernambuco, Pernambuco, Brazil; Graduate Program in Rehabilitation and Functional Performance, Universidade de Pernambuco, Petrolina, Pernambuco, Brazil
| | - Emilly C N Hora
- Universidade Federal de Sergipe, Aracaju, Pernambuco, Brazil
| | - Lívia B Andrade
- Professor Fernando Figueira Integral Medicine Institute, Recife, Pernambuco, Brazil
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Harrod EG, Shrira I, Martin JD, Niedenthal PM. Living in ancestrally diverse states of the United States is associated with greater vagal tone. Front Psychol 2023; 13:1068456. [PMID: 36710751 PMCID: PMC9879658 DOI: 10.3389/fpsyg.2022.1068456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 12/16/2022] [Indexed: 01/15/2023] Open
Abstract
Historically, exposure to dissimilar others ("strangers") was a physiologically arousing event-resulting in avoidance, distrust, and even conflict. Despite this, contemporary migration patterns are increasing intergroup contact. What gives rise to an individual's ability to regulate their arousal such that social engagement with outgroup members is possible? We propose that cultural practices that evolve in ancestrally diverse, compared to ancestrally homogeneous, societies provide more opportunities for society members to engage in emotion regulation. This regulatory exercise, in turn, promotes higher vagal tone-a physiological indicator of one's ability to effectively manage arousal in social interaction. In a secondary analysis of data from the MIDUS 2 Biomarker Project, we find that the ancestral diversity of the states of the United States significantly predicts the average vagal tone of the state's citizens. The findings suggest that social context is associated with predictable and significant adaptations of human physiology over individual lifetimes.
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Affiliation(s)
- Ethan G. Harrod
- Department of Psychology, The University of Wisconsin-Madison, Madison, WI, United States,*Correspondence: Ethan G. Harrod, ✉
| | - Ilan Shrira
- Department of Psychology, Pennsylvania State University, State College, PA, United States
| | | | - Paula M. Niedenthal
- Department of Psychology, The University of Wisconsin-Madison, Madison, WI, United States
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Emotional Self-Regulation in Primary Education: A Heart Rate-Variability Biofeedback Intervention Programme. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095475. [PMID: 35564869 PMCID: PMC9099602 DOI: 10.3390/ijerph19095475] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 04/19/2022] [Accepted: 04/28/2022] [Indexed: 02/04/2023]
Abstract
This study investigated the benefits of using a biofeedback intervention programme to train children in controlling their heart rate variability (HRV) through slow-paced breathing in real time. HRV biofeedback interventions focused on showing subjects to breathe such that their HRV numbers rise, improving their self-regulation. The HRV biofeedback intervention, focused on breathing, was conducted with primary education students aged between 7 and 11 years. The programme consisted of five biofeedback sessions, where students were taught to breathe six long and slow pairs of breaths per minute, to increase their HRV. After participation in the programme, students, regardless of gender, increased their HRV in a statistically significant fashion with a large effect, but this effect was not the same for all ages. HRV biofeedback interventions are rarely applied in schools and given the effectiveness of the intervention to improve HRV in children, the applied implications of our results in educational settings are discussed, especially taking into account the children’s ages.
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Patural H, Franco P, Pichot V, Giraud A. Heart Rate Variability Analysis to Evaluate Autonomic Nervous System Maturation in Neonates: An Expert Opinion. Front Pediatr 2022; 10:860145. [PMID: 35529337 PMCID: PMC9069105 DOI: 10.3389/fped.2022.860145] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Accepted: 03/15/2022] [Indexed: 02/03/2023] Open
Abstract
While heart rate variability (HRV) is a relevant non-invasive tool to assess the autonomic nervous system (ANS) functioning with recognized diagnostic and therapeutic implications, the lack of knowledge on its interest in neonatal medicine is certain. This review aims to briefly describe the algorithms used to decompose variations in the length of the RR interval and better understand the physiological autonomic maturation data of the newborn. Assessing newborns' autonomous reactivity can identify dysautonomia situations and discriminate children with a high risk of life-threatening events, which should benefit from cardiorespiratory monitoring at home. Targeted monitoring of HRV should provide an objective reflection of the newborn's intrinsic capacity for cardiorespiratory self-regulation.
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Affiliation(s)
- Hugues Patural
- Neonatal and Pediatric Intensive Care Department, Centre Hospitalier Universitaire de Saint-Étienne, Saint-Étienne, France
- INSERM, U1059, SAINBIOSE, Université de Lyon, Université Jean-Monnet, Saint-Étienne, France
| | - Patricia Franco
- Sleep and Neurological Functional Explorations, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Lyon, France
| | - Vincent Pichot
- INSERM, U1059, SAINBIOSE, Université de Lyon, Université Jean-Monnet, Saint-Étienne, France
| | - Antoine Giraud
- Neonatal and Pediatric Intensive Care Department, Centre Hospitalier Universitaire de Saint-Étienne, Saint-Étienne, France
- INSERM, U1059, SAINBIOSE, Université de Lyon, Université Jean-Monnet, Saint-Étienne, France
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Nguyen Van S, Lobo Marques JA, Biala TA, Li Y. Identification of Latent Risk Clinical Attributes for Children Born Under IUGR Condition Using Machine Learning Techniques. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2021; 200:105842. [PMID: 33257111 DOI: 10.1016/j.cmpb.2020.105842] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 11/10/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND AND OBJECTIVE Intrauterine Growth Restriction (IUGR) is a condition in which a fetus does not grow to the expected weight during pregnancy. There are several well documented causes in the literature for this issue, such as maternal disorder, and genetic influences. Nevertheless, besides the risk during pregnancy and labour periods, in a long term perspective, the impact of IUGR condition during the child development is an area of research itself. The main objective of this work is to propose a machine learning solution to identify the most significant features of importance based on physiological, clinical or socioeconomic factors correlated with previous IUGR condition after 10 years of birth. METHODS In this work, 41 IUGR (18 male) and 34 Non-IUGR (22 male) children were followed up 9 years after the birth, in average (9.1786 ± 0.6784 years old). A group of machine learning algorithms is proposed to classify children previously identified as born under IUGR condition based on 24-hours monitoring of ECG (Holter) and blood pressure (ABPM), and other clinical and socioeconomic attributes. In additional, an algorithm of relevance determination based on the classifier is also proposed, to determine the level of importance of the considered features. RESULTS The proposed classification solution achieved accuracy up to 94.73%, and better performance than seven state-of-the-art machine learning algorithms. Also, relevant latent factors related to HRV and BP monitoring are proposed, such as: day-time heart rate (day-time HR), day-night systolic blood pressure (day-night SBP), 24-hour standard deviation (SD) of SBP, dropped, morning cortisol creatinine, 24-hour mean of SDs of all NN intervals for each 5 minutes segment (24-hour SDNNi), among others. CONCLUSION With outstanding accuracy of our proposed solutions, the classification system and the indication of relevant attributes may support medical teams on the clinical monitoring of IUGR children during their childhood development.
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Affiliation(s)
- Sau Nguyen Van
- Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China.
| | | | - T A Biala
- University of Leicester, Leicester, UK and the Biotechnology Research Center, Lybia.
| | - Ye Li
- Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China.
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Korkalainen N, Mäkikallio T, Räsänen J, Huikuri H, Mäkikallio K. Antenatal hemodynamic findings and heart rate variability in early school-age children born with fetal growth restriction. J Matern Fetal Neonatal Med 2019; 34:2267-2273. [PMID: 31510812 DOI: 10.1080/14767058.2019.1663816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND According to epidemiological studies, impaired intrauterine growth increases the risk for cardiovascular morbidity and mortality in adulthood. Heart rate variability (HRV), which reflects the autonomic nervous system function, has been used for risk assessment in adults while its dysfunction has been linked to poor cardiovascular outcome. OBJECTIVE We hypothesized that children who were born with fetal growth restriction (FGR) and antenatal blood flow redistribution have decreased HRV at early school age compared to their gestational age matched peers with normal intrauterine growth. STUDY DESIGN A prospectively collected cohort of children born with FGR (birth weight <10th percentile and/or abnormal umbilical artery flow, n = 28) underwent a 24-hour Holter monitoring at the mean age of 9 years and gestational age matched children with birth weight appropriate for gestational age (AGA, n = 19) served as controls. Time- and frequency domain HRV indices were measured and their associations with antenatal hemodynamic changes were analyzed. RESULTS Time- and frequency domain HRV parameters (standard deviation of R-R intervals, SDNN; low frequency, LF; high frequency, HF; LF/HF; very low frequency, VLF) did not differ significantly between FGR and AGA groups born between 24 and 40 weeks. Neither did they differ between children born with FGR and normal umbilical artery pulsatility or increased umbilical artery pulsatility. In total, 56% of the FGR children demonstrated blood flow redistribution (cerebroplacental ratio, CPR < -2 SD) during fetal life and their SDNN (p = .01), HF (p = .03) and VLF (p = .03) values were significantly lower than in FGR children with CPR ≥ -2SD. CONCLUSIONS Early school age children born with FGR and intrauterine blood flow redistribution demonstrated altered heart rate variability. These prenatal and postnatal findings may be helpful in targeting preventive cardiovascular measures in FGR.
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Affiliation(s)
- Noora Korkalainen
- Department of Obstetrics and Gynecology, Oulu University Hospital and University of Oulu, Oulu, Finland.,PEDEGO Research Group, University of Oulu, Oulu, Finland
| | - Timo Mäkikallio
- Department of Cardiology, Oulu University Hospital, Oulu, Finland
| | - Juha Räsänen
- Department of Obstetrics and Gynecology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Heikki Huikuri
- Department of Cardiology, Oulu University Hospital, Oulu, Finland
| | - Kaarin Mäkikallio
- Department of Obstetrics and Gynecology, Turku University Hospital and University of Turku, Turku, Finland
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Autonomic maturation from birth to 2 years: normative values. Heliyon 2019; 5:e01300. [PMID: 30899829 PMCID: PMC6407160 DOI: 10.1016/j.heliyon.2019.e01300] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2018] [Revised: 02/03/2019] [Accepted: 02/27/2019] [Indexed: 01/11/2023] Open
Abstract
Background While heart rate variability (HRV) constitutes a relevant non-invasive tool to assess the autonomic nervous system (ANS) function with recognized diagnostic or therapeutic implications, there is still a lack of established data on maturation of autonomic control of heart rate during the first months of life. The Autonomic Baby Evaluation (AuBE) cohort was built to establish, the normal autonomic maturation profile from birth up to 2 years, in a healthy population of full-term newborns. Methods Heart rate variability analysis was carried out in 271 full-term newborns (mean gestational age 39 wGA + 5 days) from reliable polysomnographic recordings at 0 (n = 270) and 6 (n = 221) months and from a 24-hour ambulatory electrocardiogram (ECG) at 12 (n = 210), 18 (n = 197), and 24 (n = 190) months. Indices of HRV analysis were calculated through the ANSLabTools software. Results Indices are dissociated according a temporal, geometrical, frequency, Poincaré, empirical mode decomposition, fractal, Chaos and DC/AC and entropy analysis. Each index is presented for five different periods of time, 0, 6, 12, 18 and 24 months and with smoothed values in the 3rd, 10th, 50th, 90th and 97th percentiles. Data are also presented for the full cohort and individualized by sex to account for gender variability. Discussion & conclusion The physiological autonomic maturation profile from birth to 2 years in a healthy population of term neonates results in a fine-tuning autonomic maturation underlying progressively a new equilibrium and privileging the parasympathetic activity over the sympathetic activity.
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8
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Autonomic dysfunction in programmed hypertension. J Hum Hypertens 2018; 33:267-276. [PMID: 30518808 DOI: 10.1038/s41371-018-0142-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Revised: 10/31/2018] [Accepted: 11/21/2018] [Indexed: 02/07/2023]
Abstract
Hypertension is an important modifiable risk factor for cardiovascular diseases. Its high prevalence, combined with the significant morbidity and mortality associated with secondary complications, make it a major public health concern. Despite decades of research, over 95% of all cases of hypertension remain of unknown etiology, necessitating that treatments target the established symptoms and not the cause. One of the important recent advances in hypertension research is an understanding that hypertension often may have a developmental origin. A substantial body of evidence indicates that exposure to an adverse intrauterine environment during critical periods of development may predispose an individual to develop hypertension later in life. A causative mechanism has yet to be identified, but may include epigenetic modifications, and/or alterations in renal, vascular or autonomic cardiovascular functions. This review will present evidence regarding changes in autonomic activity as a possible causative pathophysiological mechanism underlying the development of programmed hypertension. In man, low birth weight is the best-known risk factor for hypertension of developmental origins, although this is a broad surrogate measure for intrauterine adversity. This review will include clinical studies across the lifespan that have investigated autonomic function in individuals with fetal growth restriction and those born preterm. A determination of whether altered autonomic function is seen in these individuals in early life is imperative, as hypertensive disorders that have their origins in utero, and that can be identified early, will open the door to risk stratification, and the development of new strategies that prevent or specifically target these mechanisms.
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Dissanayake HU, McMullan RL, Kong Y, Caterson ID, Celermajer DS, Phang M, Raynes-Greenow C, Polson JW, Gordon A, Skilton MR. Body Fatness and Cardiovascular Health in Newborn Infants. J Clin Med 2018; 7:jcm7090270. [PMID: 30208579 PMCID: PMC6162858 DOI: 10.3390/jcm7090270] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Revised: 09/04/2018] [Accepted: 09/08/2018] [Indexed: 11/16/2022] Open
Abstract
Birth weight is associated with cardiovascular disease, with those at both ends of the spectrum at increased risk. However, birth weight is a crude surrogate of fetal growth. Measures of body composition may more accurately identify high risk infants. We aimed to determine whether aortic wall thickening, cardiac autonomic control, and cardiac structure/function differ in newborns with high or low body fatness compared to those with average body fatness. 189 healthy singleton term born neonates were recruited and stratified by body fat percentiles (sex and gestation-specific). Infants with low body fat had higher aortic intima-media thickness (43 µm (95% confidence interval (CI) 7, 78), p = 0.02), lower heart rate variability (log total power, -0.5 (95% CI -0.8, -0.1), p = 0.008), and thicker ventricular walls (posterior wall thickness, 3.1 mm (95% CI 1.6, 4.6), p < 0.001) compared to infants with average body fatness. Infants with high body fat showed no differences in aortic intima-media thickness (-2 µm (95% CI -37, 33), p = 0.91) or cardiac structure compared to average body fatness, although stroke volume (-0.3 mL/kg (95% CI -0.6, -0.0), p = 0.003) and heart rate variability were lower (log total power, -0.8 (95% CI -1.1, -0.5), p < 0.001). The non-linear association of body fatness with heart rate variability was independent of birth weight. Infants born with low or high body fat have altered markers of cardiovascular health. Assessment of body fatness alongside birth weight may assist in identifying high risk individuals.
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Affiliation(s)
- Hasthi U Dissanayake
- Boden Institute of Obesity, Charles Perkins Centre, University of Sydney, Sydney, NSW 2006, Australia.
- Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, Sydney, NSW 2006, Australia.
| | - Rowena L McMullan
- Boden Institute of Obesity, Charles Perkins Centre, University of Sydney, Sydney, NSW 2006, Australia.
- Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, Sydney, NSW 2006, Australia.
- Royal Prince Alfred Hospital, Missenden Road, Camperdown, NSW 2050, Australia.
| | - Yang Kong
- Boden Institute of Obesity, Charles Perkins Centre, University of Sydney, Sydney, NSW 2006, Australia.
- Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, Sydney, NSW 2006, Australia.
| | - Ian D Caterson
- Boden Institute of Obesity, Charles Perkins Centre, University of Sydney, Sydney, NSW 2006, Australia.
| | - David S Celermajer
- Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, Sydney, NSW 2006, Australia.
- Royal Prince Alfred Hospital, Missenden Road, Camperdown, NSW 2050, Australia.
| | - Melinda Phang
- Boden Institute of Obesity, Charles Perkins Centre, University of Sydney, Sydney, NSW 2006, Australia.
| | | | - Jaimie W Polson
- Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, Sydney, NSW 2006, Australia.
- School of Medical Sciences & Bosch Institute, The University of Sydney, Sydney, NSW 2006, Australia.
| | - Adrienne Gordon
- Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, Sydney, NSW 2006, Australia.
- Royal Prince Alfred Hospital, Missenden Road, Camperdown, NSW 2050, Australia.
| | - Michael R Skilton
- Boden Institute of Obesity, Charles Perkins Centre, University of Sydney, Sydney, NSW 2006, Australia.
- Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, Sydney, NSW 2006, Australia.
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Lakhno IV. The hemodynamic repercussions of the autonomic modulations in growth-restricted fetuses. ALEXANDRIA JOURNAL OF MEDICINE 2017. [DOI: 10.1016/j.ajme.2016.12.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Affiliation(s)
- Igor Victorovich Lakhno
- Department of Perinatology, Obstetrics and Gynecology, Department of Kharkiv Medical Academy of Postgraduate Education, Amosova Str., 58, 61176 Kharkiv, Ukraine
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Cohen E, Wong FY, Wallace EM, Mockler JC, Odoi A, Hollis S, Horne RSC, Yiallourou SR. Fetal-growth-restricted preterm infants display compromised autonomic cardiovascular control on the first postnatal day but not during infancy. Pediatr Res 2017; 82:474-482. [PMID: 28388597 DOI: 10.1038/pr.2017.105] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Accepted: 04/03/2017] [Indexed: 12/26/2022]
Abstract
BackgroundFetal growth restriction (FGR) is associated with increased perinatal mortality and long-term cardiovascular and neurodevelopmental sequelae. We hypothesized that FGR impacts on the development of autonomic heart rate and blood pressure control, contributing to unfavorable short- and long-term outcomes following FGR.MethodsWe studied 25 preterm FGR and 22 preterm and 19 term appropriate for gestational age (AGA) infants. Preterm neonates were studied on postnatal day 1, and all infants were studied at 1 and 6 months post-term age. To investigate autonomic cardiovascular control, we examined heart rate variability (HRV) and baroreflex sensitivity using spectral power and transfer-function analyses.ResultsPreterm FGR neonates exhibited higher heart rates and reduced HRV compared with preterm AGA controls on postnatal day 1. No significant differences were found between the three groups at 1 or 6 months post-term age.ConclusionPreterm FGR neonates display compromised HRV on postnatal day 1, which may suggest increased vulnerability to circulatory instability. This may predispose these neonates to systemic and cerebral hypoperfusion and increase the risk of long-term neurodevelopmental sequelae. Differences were no longer found at 1 and 6 months post-term age, suggesting that the maturation of autonomic cardiovascular control may be preserved following FGR.
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Affiliation(s)
- Emily Cohen
- The Ritchie Centre, Hudson Institute of Medical Research and Department of Paediatrics Monash University, Melbourne, Victoria, Australia
| | - Flora Y Wong
- The Ritchie Centre, Hudson Institute of Medical Research and Department of Paediatrics Monash University, Melbourne, Victoria, Australia
| | - Euan M Wallace
- The Ritchie Centre, Department of Obstetrics and Gynaecology, Monash University, Melbourne, Victoria, Australia
| | - Joanne C Mockler
- Department of Obstetrics and Gynaecology, Monash University and Monash Women's, Monash Health, Melbourne, Victoria, Australia
| | - Alexsandria Odoi
- The Ritchie Centre, Hudson Institute of Medical Research and Department of Paediatrics Monash University, Melbourne, Victoria, Australia
| | - Samantha Hollis
- The Ritchie Centre, Hudson Institute of Medical Research and Department of Paediatrics Monash University, Melbourne, Victoria, Australia
| | - Rosemary S C Horne
- The Ritchie Centre, Hudson Institute of Medical Research and Department of Paediatrics Monash University, Melbourne, Victoria, Australia
| | - Stephanie R Yiallourou
- The Ritchie Centre, Hudson Institute of Medical Research and Department of Paediatrics Monash University, Melbourne, Victoria, Australia
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Koenig J, Rash JA, Campbell TS, Thayer JF, Kaess M. A Meta-Analysis on Sex Differences in Resting-State Vagal Activity in Children and Adolescents. Front Physiol 2017; 8:582. [PMID: 28883794 PMCID: PMC5573740 DOI: 10.3389/fphys.2017.00582] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Accepted: 07/28/2017] [Indexed: 12/17/2022] Open
Abstract
Lower vagal activity is associated with psychopathology independent of age. Research suggests that alterations of vagal activity precede the development of psychopathology. The present review aimed to quantify sex differences in vagal activity in children and adolescents. Studies reporting on sex differences on measures of vagally-mediated heart rate variability derived from short-term recordings under resting conditions in boys and girls were included. Drawing on data from more than 5,000 children and adolescents, we provide evidence that healthy young girls display lower vagal activity and greater mean heart rate compared to boys, a finding that may have implications for risk associated with the development of internalizing psychopathology and somatic ill-health.
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Affiliation(s)
- Julian Koenig
- Section for Translational Psychobiology in Child and Adolescent Psychiatry, Department for Child and Adolescent Psychiatry, Centre of Psychosocial Medicine, University of HeidelbergHeidelberg, Germany
| | - Joshua A Rash
- Department of Psychology, University of CalgaryCalgary, AB, Canada.,Department of Psychology, Memorial University of NewfoundlandSt. John's, NL, Canada
| | - Tavis S Campbell
- Department of Psychology, University of CalgaryCalgary, AB, Canada
| | - Julian F Thayer
- Department of Psychology, The Ohio State UniversityColumbus, OH, United States
| | - Michael Kaess
- Section for Translational Psychobiology in Child and Adolescent Psychiatry, Department for Child and Adolescent Psychiatry, Centre of Psychosocial Medicine, University of HeidelbergHeidelberg, Germany.,University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of BernBern, Switzerland
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Lakhno IV. The Autonomic Repercussions of Fetal and Maternal Interaction in Pre-eclampsia. SERBIAN JOURNAL OF EXPERIMENTAL AND CLINICAL RESEARCH 2017. [DOI: 10.1515/sjecr-2017-0018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Pre-eclampsia (PE) is one of the severe complications of pregnancy that leads to fetal deterioration. The aim of the investigation was to determine the role of maternal respiratory sinus arrhythmia (RSA) in regulation of fetal circulatory system in case of healthy pregnancy and in PE.
The investigation of maternal and fetal HRV and umbilical venous blood flow velocity spectral analysis in 106 patients at 34-40 weeks of gestation was performed. 30 of them had healthy pregnancy and were involved in the Group I. In Group II 44 pregnant women with mild-moderate PE were observed. 32 patients with severe PE were monitored in Group III. The maternal sympathetic overactivity modulated HRV in PE. The suppression of RSA was explored in preeclamptic patients. The Doppler spectrograms of the umbilical veinous blod flow had the oscillatory peak with a frequency about 0.5 Hz. The above peak characterized the participation of the maternal RSA in fetal hemodynamics. Strong relationship between maternal RMSSD and amplitude of RSA associated peak, maternal and fetal RMSSDs was found in healthy pregnancy. No considerable relationship was revealed between the maternal RMSSD and the amplitude of 0.5 Hz frequency peak, the maternal and fetal RMSSDs in the patients with severe PE. The maternal RSA propagated its influence on the fetal umbilical venous blood flow and the fetal autonomic nervous regulation in normal gestation. The control of fetal hemodynamics diminished in the mild-moderate PE and even disappeared in severe PE.
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Schierz IAM, Pinello G, Piro E, Giuffrè M, La Placa S, Corsello G. Transitional hemodynamics in infants of diabetic mothers by targeted neonatal echocardiography, electrocardiography and peripheral flow study. J Matern Fetal Neonatal Med 2017; 31:1578-1585. [PMID: 28412852 DOI: 10.1080/14767058.2017.1320544] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVE Metabolic alterations of intrauterine environment in diabetes mellitus (DM) lead to fetal cardiac dysfunctions that can persist after birth. The aim of the study was to assess the cardiovascular adaptation in infants born to diabetic mothers (IDM) with different degrees of glycometabolic control, in relation to revised guidelines for diagnosis of DM and quality improvements in neonatal care. MATERIALS AND METHODS An observational case-control study was conducted on IDM with gestational, type 1 and type 2 DM. Relevant maternal and neonatal anamnestic, clinical and laboratory data were analyzed. Electrocardiographic and echocardiographic analyses, including structural and systo-diastolic evaluation, were performed. RESULTS In 68 IDM enrolled, we observed a lower incidence of negative perinatal outcome than expected. Comparing to non-IDM, they presented larger fetal shunts, higher pulmonary pressures, early and atrial wave velocities. At 72 hours, kinesis and heart rate variability remained low. Cerebral blood flow velocities were higher. The most serious impairment of transition was in pregestational IDM. CONCLUSION Maternal DM impaired neonatal transitional hemodynamics also in asymptomatic IDM with good glycometabolic control. These results confirm the need for an early cardiologic and cerebrovascular evaluation, to identify IDM with delayed maturation at risk of worse long-term metabolic, cardiovascular, and neurodevelopmental outcome.
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Affiliation(s)
- Ingrid Anne Mandy Schierz
- a Neonatal Intensive Care Unit, A.O.U.P. "P. Giaccone", Department of Sciences for Health Promotion and Mother and Child Care "G. D'Alessandro" , University of Palermo , Palermo , Italy
| | - Giuseppa Pinello
- a Neonatal Intensive Care Unit, A.O.U.P. "P. Giaccone", Department of Sciences for Health Promotion and Mother and Child Care "G. D'Alessandro" , University of Palermo , Palermo , Italy
| | - Ettore Piro
- a Neonatal Intensive Care Unit, A.O.U.P. "P. Giaccone", Department of Sciences for Health Promotion and Mother and Child Care "G. D'Alessandro" , University of Palermo , Palermo , Italy
| | - Mario Giuffrè
- a Neonatal Intensive Care Unit, A.O.U.P. "P. Giaccone", Department of Sciences for Health Promotion and Mother and Child Care "G. D'Alessandro" , University of Palermo , Palermo , Italy
| | - Simona La Placa
- a Neonatal Intensive Care Unit, A.O.U.P. "P. Giaccone", Department of Sciences for Health Promotion and Mother and Child Care "G. D'Alessandro" , University of Palermo , Palermo , Italy
| | - Giovanni Corsello
- a Neonatal Intensive Care Unit, A.O.U.P. "P. Giaccone", Department of Sciences for Health Promotion and Mother and Child Care "G. D'Alessandro" , University of Palermo , Palermo , Italy
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15
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Abstract
According to metabolic programming theory, small-for-gestational age patients are at high risk of cardiovascular diseases also because of the possible malfunction of the autonomic nervous system. Autonomic disorders can be assessed by heart rate variability. The aims of this study were to compare time domain parameters of heart rate variability in children born as small-for-gestational age and appropriate-for-gestational age and to assess the correlation of the postnatal and current somatic parameters with the time domain parameters. The small-for-gestational age group consisted of 68 children aged 5-10 years who were born with birth weight below the 10th percentile. The appropriate-for-gestational age group consisted of 30 healthy peers, matched in terms of gender and age. On the basis of Holter monitoring, slightly higher average heart rate was observed in the small-for-gestational age group than in the appropriate-for-gestational age group. It was found that all the time domain parameters (SDNN, SDNNi, SDANNi, rMSSD, pNN50) were lower in the small-for-gestational age group than in the appropriate-for-gestational age group. In the small-for-gestational age group, girls had lower heart rate and some of the heart rate variability parameters (SDNN, SDNNi, SDANNi) in comparison with boys. Children born as small-for-gestational age have impaired function of the autonomic nervous system. Moreover, in the small-for-gestational age group, autonomic balance moved towards the sympathetic component, which was evidenced by higher heart rate. Children with faster heart rate and lower heart rate variability parameters may be at risk of cardiovascular disease.
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16
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Nordenstam F, Lundell B, Cohen G, Tessma MK, Raaschou P, Wickström R. Prenatal Exposure to Snus Alters Heart Rate Variability in the Infant. Nicotine Tob Res 2017; 19:797-803. [DOI: 10.1093/ntr/ntx035] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2016] [Accepted: 02/02/2017] [Indexed: 11/13/2022]
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17
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Lakhno I. Autonomic imbalance captures maternal and fetal circulatory response to pre-eclampsia. Clin Hypertens 2017; 23:5. [PMID: 28191323 PMCID: PMC5297203 DOI: 10.1186/s40885-016-0061-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Accepted: 12/29/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Pre-eclampsia (PE) is a gestational disease featured by hypertension, arterial systemic vasculopathy, multiple organ failure and fetal compromise. The aim of the investigation was to determine the role of maternal respiratory sinus arrhythmia (RSA) in regulation of the fetal circulatory system in case of healthy pregnancy and in PE. METHODS The investigation of maternal and fetal HRV and fetal CTG variables in 106 patients at 34-40 weeks of gestation was performed. 30 of them had healthy pregnancy and were involved in the Group I. In Group II 44 pregnant women with mild-moderate PE were observed. 32 patients with severe PE were monitored in Group III. RESULT The maternal sympathetic overactivity modulated HRV in PE by suppressing total power (TP) and parasympathetic tone. The lack of RSA was explored in preeclamptic patients. The centralization of hemodynamics was a result of the hypersympatheticotonia in severe PE. Fetal circulatory response to PE featured by an increased sympathetic tone. The modulated fetal CTG variables captured the suppression of fetal biophysical activity and the development of fetal distress in severe PE. Strong relationship between maternal and fetal TPs, maternal and fetal RMSSDs was found in healthy pregnancy. The correlations between the maternal and fetal TPs, the maternal and fetal RMSSDs in the patients with severe PE were disturbed. CONCLUSION The maternal RSA propagated its influence on the fetal autonomic nervous regulation in normal gestation. The maternal and fetal hemodynamic coupling was reduced in PE.
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Affiliation(s)
- Igor Lakhno
- Kharkiv Medical Academy of Postgraduate Education, Amosova str., 58, Kharkiv, 61176 Ukraine
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18
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Kapaya H, Broughton Pipkin F, Hayes-Gill B, Loughna PV. Circadian changes and sex-related differences in fetal heart rate parameters. Matern Health Neonatol Perinatol 2016; 2:9. [PMID: 27595008 PMCID: PMC5010766 DOI: 10.1186/s40748-016-0037-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Accepted: 08/25/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Previous researchers have studied circadian changes in the fetal heart rate (FHR) on small sample sizes and in a strictly controlled environment. This study was undertaken to investigate these changes during the late second and third trimesters, using a portable fetal electrocardiogram recording device (Monica AN24) in pregnant women in home and hospital environments with unrestricted mobility. METHODS This was a prospective cohort study of 54 pregnant women with uncomplicated singleton pregnancies between 25 and 40 weeks gestation. FHR recordings were made up to 16 h at home or in the hospital setting in the United Kingdom. FHR data over 90 min periods were averaged and the day (7:00 am-11:00 pm) and night (11:00 pm-7:00 am) data from the same individual were compared. Data were examined for evidence of sex-related differences. RESULTS During the night, there was a significant reduction in basal heart rate (bFHR) and a significant increase in short term variation (STV) and long term variation (LTV) (P < 0.05). Basal FHR decreased (P < 0.002), whereas LTV increased (P = 0.014) with advancing gestation. Male fetuses showed greater day: night variation than females regardless of gestation (P = 0.014). There was a higher bFHR in fetuses monitored during the day in hospital (P = 0.04). CONCLUSION This study demonstrates that there are sex-, environment and time-related differences in the FHR parameters measured. These differences may need to be considered taken when interpreting FHR data.
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Affiliation(s)
- Habiba Kapaya
- Department of Oncology and Metabolism, Academic Unit of Reproductive & Developmental Medicine, 4th Floor Jessop Wing, Tree Root Walk, Sheffield, S102SF UK
| | - Fiona Broughton Pipkin
- Division of Child Health, Obstetrics and Gynaecology, School of Medicine, University of Nottingham, Nottingham, NG7 2RD UK
| | - Barrie Hayes-Gill
- Electrical Systems and Optics Research Division, University of Nottingham, University Park, Nottingham, NG7 2RD UK
| | - Pamela V Loughna
- Division of Child Health, Obstetrics and Gynaecology, School of Medicine, University of Nottingham, Nottingham, NG7 2RD UK
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Perkiömäki N, Auvinen J, Tulppo MP, Hautala AJ, Perkiömäki J, Karhunen V, Keinänen-Kiukaanniemi S, Puukka K, Ruokonen A, Järvelin MR, Huikuri HV, Kiviniemi AM. Association between Birth Characteristics and Cardiovascular Autonomic Function at Mid-Life. PLoS One 2016; 11:e0161604. [PMID: 27552091 PMCID: PMC4994955 DOI: 10.1371/journal.pone.0161604] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Accepted: 08/08/2016] [Indexed: 12/19/2022] Open
Abstract
Background Low birth weight is associated with an increased risk of cardiovascular diseases in adulthood. As abnormal cardiac autonomic function is a common feature in cardiovascular diseases, we tested the hypothesis that low birth weight may also be associated with poorer cardiac autonomic function in middle-aged subjects. Methods At the age of 46, the subjects of the Northern Finland Birth Cohort 1966 were invited to examinations including questionnaires about health status and life style and measurement of vagally-mediated heart rate variability (rMSSD) from R-R intervals (RRi) and spontaneous baroreflex sensitivity (BRS) in both seated and standing positions. Maternal parameters had been collected in 1965–1966 since the 16th gestational week and birth variables immediately after delivery. For rMSSD, 1,799 men and 2,279 women without cardiorespiratory diseases and diabetes were included and 902 men and 1,020 women for BRS. The analyses were adjusted for maternal (age, anthropometry, socioeconomics, parity, gestational smoking) and adult variables (life style, anthropometry, blood pressure, glycemic and lipid status) potentially confounding the relationship between birth weight and autonomic function. Results In men, birth weight correlated negatively with seated (r = -0.058, p = 0.014) and standing rMSSD (r = -0.090, p<0.001), as well as with standing BRS (r = -0.092, p = 0.006). These observations were verified using relevant birth weight categories (<2,500 g; 2,500–3,999 g; ≥4,000 g). In women, birth weight was positively correlated with seated BRS (r = 0.081, p = 0.010), but none of the other measures of cardiovascular autonomic function. These correlations remained significant after adjustment for potential confounders (p<0.05 for all). Conclusions In men, higher birth weight was independently associated with poorer cardiac autonomic function at mid-life. Same association was not observed in women. Our findings suggest that higher, not lower, birth weight in males may contribute to less favourable cardiovascular autonomic regulation and potentially to an elevated cardiovascular risk in later life.
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Affiliation(s)
- Nelli Perkiömäki
- Research Unit of Internal Medicine, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Juha Auvinen
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
- Unit of Primary Health Care, Oulu University Hospital, Oulu, Finland
| | - Mikko P. Tulppo
- Research Unit of Internal Medicine, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Arto J. Hautala
- Physiological Signal Analysis Team, Center for Machine Vision and Signal Analysis, University of Oulu, Oulu, Finland
| | - Juha Perkiömäki
- Research Unit of Internal Medicine, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Ville Karhunen
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
| | - Sirkka Keinänen-Kiukaanniemi
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
- Unit of Primary Health Care, Oulu University Hospital, Oulu, Finland
| | - Katri Puukka
- NordLab Oulu, Medical Research Center Oulu, Oulu University Hospital and Department of Clinical Chemistry, University of Oulu, Finland
| | - Aimo Ruokonen
- NordLab Oulu, Medical Research Center Oulu, Oulu University Hospital and Department of Clinical Chemistry, University of Oulu, Finland
| | - Marjo-Riitta Järvelin
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
- Unit of Primary Health Care, Oulu University Hospital, Oulu, Finland
- Department of Epidemiology and Biostatistics, MRC–PHE Centre for Environment & Health, School of Public Health, Imperial College London, London, United Kingdom
- Biocenter Oulu, University of Oulu, Oulu, Finland
| | - Heikki V. Huikuri
- Research Unit of Internal Medicine, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Antti M. Kiviniemi
- Research Unit of Internal Medicine, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- * E-mail:
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20
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Kazmi SZH, Zhang H, Aziz W, Monfredi O, Abbas SA, Shah SA, Kazmi SSH, Butt WH. Inverse Correlation between Heart Rate Variability and Heart Rate Demonstrated by Linear and Nonlinear Analysis. PLoS One 2016; 11:e0157557. [PMID: 27336907 PMCID: PMC4919077 DOI: 10.1371/journal.pone.0157557] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2016] [Accepted: 06/01/2016] [Indexed: 11/18/2022] Open
Abstract
The dynamical fluctuations in the rhythms of biological systems provide valuable information about the underlying functioning of these systems. During the past few decades analysis of cardiac function based on the heart rate variability (HRV; variation in R wave to R wave intervals) has attracted great attention, resulting in more than 17000-publications (PubMed list). However, it is still controversial about the underling mechanisms of HRV. In this study, we performed both linear (time domain and frequency domain) and nonlinear analysis of HRV data acquired from humans and animals to identify the relationship between HRV and heart rate (HR). The HRV data consists of the following groups: (a) human normal sinus rhythm (n = 72); (b) human congestive heart failure (n = 44); (c) rabbit sinoatrial node cells (SANC; n = 67); (d) conscious rat (n = 11). In both human and animal data at variant pathological conditions, both linear and nonlinear analysis techniques showed an inverse correlation between HRV and HR, supporting the concept that HRV is dependent on HR, and therefore, HRV cannot be used in an ordinary manner to analyse autonomic nerve activity of a heart.
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Affiliation(s)
- Syed Zaki Hassan Kazmi
- School of Physics & Astronomy, University of Manchester, Manchester, United Kingdom
- Department of CS&IT, University of Azad Jammu and Kashmir, Muzaffarabad, Pakistan
- * E-mail:
| | - Henggui Zhang
- School of Physics & Astronomy, University of Manchester, Manchester, United Kingdom
| | - Wajid Aziz
- Department of CS&IT, University of Azad Jammu and Kashmir, Muzaffarabad, Pakistan
- Department of Computer Science Faculty of Computing &IT, University of Jeddah, Jeddah, Kingdom of Saudi Arabia
| | - Oliver Monfredi
- Institute of Cardiovascular Sciences, University of Manchester, Manchester, United Kingdom
| | - Syed Ali Abbas
- Department of CS&IT, University of Azad Jammu and Kashmir, Muzaffarabad, Pakistan
| | - Saeed Arif Shah
- Department of CS&IT, University of Azad Jammu and Kashmir, Muzaffarabad, Pakistan
| | | | - Wasi Haider Butt
- College of Electrical and Mechanical Engineering, National University of Sciences and Technology, Rawalpindi, Pakistan
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21
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Exploring total cardiac variability in healthy and pathophysiological subjects using improved refined multiscale entropy. Med Biol Eng Comput 2016; 55:191-205. [PMID: 27108288 DOI: 10.1007/s11517-016-1476-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2014] [Accepted: 02/23/2016] [Indexed: 10/21/2022]
Abstract
Multiscale entropy (MSE) and refined multiscale entropy (RMSE) techniques are being widely used to evaluate the complexity of a time series across multiple time scales 't'. Both these techniques, at certain time scales (sometimes for the entire time scales, in the case of RMSE), assign higher entropy to the HRV time series of certain pathologies than that of healthy subjects, and to their corresponding randomized surrogate time series. This incorrect assessment of signal complexity may be due to the fact that these techniques suffer from the following limitations: (1) threshold value 'r' is updated as a function of long-term standard deviation and hence unable to explore the short-term variability as well as substantial variability inherited in beat-to-beat fluctuations of long-term HRV time series. (2) In RMSE, entropy values assigned to different filtered scaled time series are the result of changes in variance, but do not completely reflect the real structural organization inherited in original time series. In the present work, we propose an improved RMSE (I-RMSE) technique by introducing a new procedure to set the threshold value by taking into account the period-to-period variability inherited in a signal and evaluated it on simulated and real HRV database. The proposed I-RMSE assigns higher entropy to the age-matched healthy subjects than that of patients suffering from atrial fibrillation, congestive heart failure, sudden cardiac death and diabetes mellitus, for the entire time scales. The results strongly support the reduction in complexity of HRV time series in female group, old-aged, patients suffering from severe cardiovascular and non-cardiovascular diseases, and in their corresponding surrogate time series.
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22
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Sex differences in healthy human heart rate variability: A meta-analysis. Neurosci Biobehav Rev 2016; 64:288-310. [PMID: 26964804 DOI: 10.1016/j.neubiorev.2016.03.007] [Citation(s) in RCA: 443] [Impact Index Per Article: 55.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Accepted: 03/04/2016] [Indexed: 12/17/2022]
Abstract
The present meta-analysis aimed to quantify current evidence on sex differences in the autonomic control of the heart, indexed by measures of heart rate variability (HRV) in healthy human subjects. An extensive search of the literature yielded 2020 titles and abstracts, of which 172 provided sufficient reporting of sex difference in HRV. Data from 63,612 participants (31,970 females) were available for analysis. Meta-analysis yielded a total of 1154 effect size estimates (k) across 50 different measures of HRV in a cumulated total of 296,247 participants. Females showed a significantly lower mean RR interval and standard deviation of RR intervals (SDNN). The power spectral density of HRV in females is characterized by significantly less total power that contains significantly greater high- (HF) and less low-frequency (LF) power. This is further reflected by a lower LF/HF ratio. Meta-regression revealed significant effects of age, respiration control and the length of recording available for analysis. Although women showed greater mean heart rate, they showed greater vagal activity indexed by HF power of HRV. Underlying mechanisms of these findings are discussed.
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23
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Lakhno I. The Use of Fetal Noninvasive Electrocardiography. SCIENTIFICA 2016; 2016:5386595. [PMID: 27006859 PMCID: PMC4783547 DOI: 10.1155/2016/5386595] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Revised: 01/29/2016] [Accepted: 02/01/2016] [Indexed: 06/05/2023]
Abstract
Preeclampsia (PE) is one of the severe complications of pregnancy that leads to fetal deterioration. The aim was to survey the validity of fetal distress diagnostics in case of Doppler ultrasonic umbilical vein and arteries blood flow velocity investigation and ECG parameters analysis obtained from maternal abdominal signal before labor in preeclamptic patients. Fetal noninvasive ECG and umbilical arterial and venous Doppler investigation were performed in 120 patients at 34-40 weeks of gestation. And 30 of them had physiological gestation and were involved in Group I. In Group II 52 pregnant women with mild-moderate PE were observed. 38 patients with severe PE were monitored in Group III. The most considerable negative correlation was determined in pair Apgar score 1 versus T/QRS (R = -0.50; p < 0.05). So the increased T/QRS ratio was the most evident marker of fetal distress. Fetal noninvasive ECG showed sensitivity of 96.6% and specificity of 98.4% and, therefore, was determined as more accurate method for fetal monitoring.
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Affiliation(s)
- Igor Lakhno
- Perinatology, Obstetrics and Gynecology Department, Kharkiv Medical Academy of Postgraduate Education, 58 Shalimov Street, Kharkiv 61176, Ukraine
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24
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Koren I, Michaelson-Cohen R, Chen D, Michaeli J, Schimmel M, Tsafrir A, Shen O. Intrapartum fetal heart rate patterns of trisomy 21 fetuses: A case-control study. Early Hum Dev 2016; 92:25-8. [PMID: 26624802 DOI: 10.1016/j.earlhumdev.2015.11.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2014] [Revised: 04/06/2015] [Accepted: 11/03/2015] [Indexed: 11/27/2022]
Abstract
BACKGROUND/AIM To determine whether there are specific characteristic intrapartum heart rate patterns for fetuses with trisomy 21(T21). BACKGROUND STUDY DESIGN/PATIENTS Intrapartum fetal heart rate (FHR) tracings of T21 fetuses were compared to those of euploid fetuses in a retrospective, observational, matched, case-control study. The study group consisted of 42 fetuses with T21 and 42 matched euploid controls. Matching was designed to accommodate possible confounders. The sign test and McNemar's test were used for categorical variables. The paired t test was used for comparison between quantitative variables. RESULTS Intrapartum baseline FHR of fetuses with T21 was found to be slightly decreased compared to controls (122.5 vs 129.05 beats per minute, p=0.028). No differences were detected in the presence of periodic changes, or FHR variability between the groups. CONCLUSION When evaluating intrapartum FHR of fetuses with T21, decreased baseline FHR can be expected.
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Affiliation(s)
- Inbal Koren
- Department of Pediatric Medicine, Shaare Zedek Medical Center, Jerusalem 91031, Israel
| | - Rachel Michaelson-Cohen
- Department of Obstetrics and Gynecology, Shaare Zedek Medical Center, Post Box 3125, Jerusalem 91031, Israel
| | - Daniela Chen
- Tel Aviv University, Sackler School of Medicine, Israel
| | - Jennia Michaeli
- Department of Obstetrics and Gynecology, Shaare Zedek Medical Center, Post Box 3125, Jerusalem 91031, Israel
| | - Michael Schimmel
- Department of Pediatric Medicine, Shaare Zedek Medical Center, Jerusalem 91031, Israel
| | - Avi Tsafrir
- Department of Obstetrics and Gynecology, Shaare Zedek Medical Center, Post Box 3125, Jerusalem 91031, Israel
| | - Ori Shen
- Department of Obstetrics and Gynecology, Shaare Zedek Medical Center, Post Box 3125, Jerusalem 91031, Israel.
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Marwaha P, Sunkaria RK. Optimal Selection of Threshold Value 'r' for Refined Multiscale Entropy. Cardiovasc Eng Technol 2015; 6:557-76. [PMID: 26577486 DOI: 10.1007/s13239-015-0242-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2015] [Accepted: 08/20/2015] [Indexed: 11/25/2022]
Abstract
Refined multiscale entropy (RMSE) technique was introduced to evaluate complexity of a time series over multiple scale factors 't'. Here threshold value 'r' is updated as 0.15 times SD of filtered scaled time series. The use of fixed threshold value 'r' in RMSE sometimes assigns very close resembling entropy values to certain time series at certain temporal scale factors and is unable to distinguish different time series optimally. The present study aims to evaluate RMSE technique by varying threshold value 'r' from 0.05 to 0.25 times SD of filtered scaled time series and finding optimal 'r' values for each scale factor at which different time series can be distinguished more effectively. The proposed RMSE was used to evaluate over HRV time series of normal sinus rhythm subjects, patients suffering from sudden cardiac death, congestive heart failure, healthy adult male, healthy adult female and mid-aged female groups as well as over synthetic simulated database for different datalengths 'N' of 3000, 3500 and 4000. The proposed RMSE results in improved discrimination among different time series. To enhance the computational capability, empirical mathematical equations have been formulated for optimal selection of threshold values 'r' as a function of SD of filtered scaled time series and datalength 'N' for each scale factor 't'.
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Affiliation(s)
- Puneeta Marwaha
- Department of Electronics and Communication Engineering, Dr. B R Ambedkar National Institute of Technology, Jalandhar, Punjab, 144011, India.
| | - Ramesh Kumar Sunkaria
- Department of Electronics and Communication Engineering, Dr. B R Ambedkar National Institute of Technology, Jalandhar, Punjab, 144011, India.
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Willaschek C, Meint S, Rager K, Buchhorn R. Modified Clonidine Testing for Growth Hormone Stimulation Reveals α2-Adrenoreceptor Sub Sensitivity in Children with Idiopathic Growth Hormone Deficiency. PLoS One 2015; 10:e0137643. [PMID: 26361394 PMCID: PMC4567306 DOI: 10.1371/journal.pone.0137643] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2015] [Accepted: 08/20/2015] [Indexed: 11/19/2022] Open
Abstract
Introduction The association between short stature and increased risk of ischemic heart disease has been subject to studies for decades. The recent discussion of cardiovascular risk during growth hormone therapy has given new importance to this question. We have hypothesized that the autonomic system is a crucial element relating to this subject. Methods Heart rate variability calculated from 24-hour electrocardiogram data is providing insight into the regulatory state of the autonomous nervous system and is an approved surrogate parameter for estimating cardiovascular risk. We have calculated heart rate variability during clonidine testing for growth hormone stimulation of 56 children. As clonidine is a well-known effector of the autonomous system, stimulating vagal tone and decreasing sympathetic activity, we compared the autonomous reactions of children with constitutional growth delay (CGD), growth hormone deficiency (GHD) and former small for gestational age (SGA). Results During clonidine testing children with CGD showed the expected α2-adrenoreceptor mediated autonomous response of vagal stimulation for several hours. This vagal reaction was significantly reduced in the SGA group and nearly non- existent in the GHD group. Discussion Children with GHD show a reduced autonomous response to clonidine indicating α2-adrenoreceptor sub sensitivity. This can be found prior to the start of growth hormone treatment. Since reduction of HRV is an approved surrogate parameter, increased cardiovascular risk has to be assumed for patients with GHD. In the SGA group a similar but less severe reduction of the autonomous response to clonidine was found. These findings may enrich the interpretation of the data on growth hormone therapy, which are being collected by the SAGhE study group.
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Affiliation(s)
- Christian Willaschek
- Caritas Krankenhaus, Department of Pediatrics, Bad Mergentheim, Germany
- * E-mail:
| | - Sebastian Meint
- Caritas Krankenhaus, Department of Pediatrics, Bad Mergentheim, Germany
| | - Klaus Rager
- Caritas Krankenhaus, Department of Pediatrics, Bad Mergentheim, Germany
| | - Reiner Buchhorn
- Caritas Krankenhaus, Department of Pediatrics, Bad Mergentheim, Germany
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Yiallourou SR, Wallace EM, Miller SL, Horne RSC. Effects of intrauterine growth restriction on sleep and the cardiovascular system: The use of melatonin as a potential therapy? Sleep Med Rev 2015; 26:64-73. [PMID: 26140865 DOI: 10.1016/j.smrv.2015.04.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2014] [Revised: 04/14/2015] [Accepted: 04/14/2015] [Indexed: 12/28/2022]
Abstract
Intrauterine growth restriction (IUGR) complicates 5-10% of pregnancies and is associated with increased risk of preterm birth, mortality and neurodevelopmental delay. The development of sleep and cardiovascular control are closely coupled and IUGR is known to alter this development. In the long-term, IUGR is associated with altered sleep and an increased risk of hypertension in adulthood. Melatonin plays an important role in the sleep-wake cycle. Experimental animal studies have shown that melatonin therapy has neuroprotective and cardioprotective effects in the IUGR fetus. Consequently, clinical trials are currently underway to assess the short and long term effects of antenatal melatonin therapy in IUGR pregnancies. Given melatonin's role in sleep regulation, this hormone could affect the developing infants' sleep-wake cycle and cardiovascular function after birth. In this review, we will 1) examine the role of melatonin as a therapy for IUGR pregnancies and the potential implications on sleep and the cardiovascular system; 2) examine the development of sleep-wake cycle in fetal and neonatal life; 3) discuss the development of cardiovascular control during sleep; 4) discuss the effect of IUGR on sleep and the cardiovascular system and 5) discuss the future implications of melatonin therapy in IUGR pregnancies.
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Affiliation(s)
- Stephanie R Yiallourou
- The Ritchie Centre, Monash Institute of Medical Research and Prince Henry's Institute and Monash University, Melbourne, Australia; Department of Paediatrics, Monash University, Melbourne, Australia.
| | - Euan M Wallace
- The Ritchie Centre, Monash Institute of Medical Research and Prince Henry's Institute and Monash University, Melbourne, Australia; Department of Obstetrics and Gynaecology, Monash University, Melbourne, Australia
| | - Suzanne L Miller
- The Ritchie Centre, Monash Institute of Medical Research and Prince Henry's Institute and Monash University, Melbourne, Australia; Department of Obstetrics and Gynaecology, Monash University, Melbourne, Australia
| | - Rosemary S C Horne
- The Ritchie Centre, Monash Institute of Medical Research and Prince Henry's Institute and Monash University, Melbourne, Australia; Department of Paediatrics, Monash University, Melbourne, Australia
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Aziz W, Rafique M, Ahmad I, Arif M, Habib N, Nadeem MSA. Classification of heart rate signals of healthy and pathological subjects using threshold based symbolic entropy. ACTA BIOLOGICA HUNGARICA 2014; 65:252-64. [PMID: 25194729 DOI: 10.1556/abiol.65.2014.3.2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The dynamical fluctuations of biological signals provide a unique window to construe the underlying mechanism of the biological systems in health and disease. Recent research evidences suggest that a wide class of diseases appear to degrade the biological complexity and adaptive capacity of the system. Heart rate signals are one of the most important biological signals that have widely been investigated during the last two and half decades. Recent studies suggested that heart rate signals fluctuate in a complex manner. Various entropy based complexity analysis measures have been developed for quantifying the valuable information that may be helpful for clinical monitoring and for early intervention. This study is focused on determining HRV dynamics to distinguish healthy subjects from patients with certain cardiac problems using symbolic time series analysis technique. For that purpose, we have employed recently developed threshold based symbolic entropy to cardiac inter-beat interval time series of healthy, congestive heart failure and atrial fibrillation subjects. Normalized Corrected Shannon Entropy (NCSE) was used to quantify the dynamics of heart rate signals by continuously varying threshold values. A rule based classifier was implemented for classification of different groups by selecting threshold values for the optimal separation. The findings indicated that there is reduction in the complexity of pathological subjects as compared to healthy ones at wide range of threshold values. The results also demonstrated that complexity decreased with disease severity.
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Affiliation(s)
- Wajid Aziz
- University of Azad Kashmir Department of Computer Sciences and Information Technology 13100 Azad Kashmir Pakistan
| | - M Rafique
- University of Azad Jammu and Kashmir Muzaffarbad Department of Physics 13100 Azad Kashmir Pakistan
| | - I Ahmad
- University of Azad Jammu and Kashmir Muzaffarbad Department of Mathematics 13100 Azad Kashmir Pakistan
| | - M Arif
- Um-Alqura University College of Computer and Information System, Al-Abidiyya Building P.O. Box 715 Makkah Saudi Arabia
| | - Nazneen Habib
- University of Azad Jammu and Kashmir Muzaffarbad Department of Sociology and Rural Development 13100 Azad Kashmir Pakistan
| | - M S A Nadeem
- University of Azad Kashmir Department of Computer Sciences and Information Technology 13100 Azad Kashmir Pakistan
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Heart rate variability reflects the natural history of physiological development in healthy children and is not associated with quality of life. PLoS One 2014; 9:e91036. [PMID: 24625571 PMCID: PMC3953202 DOI: 10.1371/journal.pone.0091036] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2012] [Accepted: 02/10/2014] [Indexed: 01/13/2023] Open
Abstract
Background Quality of life (QoL), being the sum expression of diverse influencing factors, is not easy to determine. A clinically relevant option would be to identify and measure quality of life on the basis of physiological parameters which correlate plausibly and statistically with psychometrically measured QoL. Analysis of heart rate variability (HRV) offers readily measurable physiological parameters which could be of use here. A correlation of HRV with both course of disease and QoL has been reported in patients with chronic illness. Various psychometric instruments have been developed for use in paediatric oncology. The aim of this study was to obtain data on HRV and QoL and their correlations, initially in healthy children. Methods Holter ECG and quality of life were examined in 160 children and adolescents (72 male) aged between 8 and 18 years. QoL was determined with the established questionnaire PEDQoL. Standard parameters of HRV from the frequency domain were calculated and correlated with QoL domains using Spearman (nonparametric) correlation analysis. Results Minor but significant associations were revealed only with regard to the PEDQoL domain “autonomy” on the one hand and heart rate and HRV (e.g. MRR, MRRn, MRRd, HRV_ULF, SDNN) parameters which evidently reflect distinct physiological functions on the other. Conclusions In healthy children and adolescents we have a first indication that there is a correlation between parameters of HRV and QoL. However, to a greater extent, HRV reflects associated physiological processes of the autonomic nervous system. A higher correlation is more likely to be found in chronically ill children.
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Patural H, Flori S, Pichot V, Barthelemy JC, Roche F. [Autonomic regulation and bradycardia during the neonatal period]. Arch Pediatr 2013; 21:226-30. [PMID: 24290181 DOI: 10.1016/j.arcped.2013.10.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2012] [Revised: 08/28/2013] [Accepted: 10/14/2013] [Indexed: 12/16/2022]
Abstract
The high frequency of bradycardia observed during the neonatal period requires cardiac monitoring but also understanding its intrinsic mechanisms, including responsiveness of the autonomic nervous system (ANS). Heart rate variability and spontaneous baroreflex analysis can help understand the autonomic dysregulation of cardiorespiratory control, possibly responsible for sudden infant death. In clinical neonatology practice, neonatal bradycardia does not warrant continuation of monitoring if it remains isolated, asymptomatic, and short (<10 s), followed by a rapid cardiac acceleration indicating an adapted sympathetic response. Further evaluation of ANS responsiveness is possible for newborns including analyzing the complexity of the heart rate and respiratory variability. This allows better targeting children with high risk after discharge. The real-time evaluation of autonomic regulation could become a valuable tool in clinical practice.
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Affiliation(s)
- H Patural
- Réanimation néonatale et pédiatrique, centre hospitalier universitaire de Saint-Étienne, 42005 Saint-Étienne, France; EA SNA-Epis 4607, université Jean-Monnet, 42023 Saint-Étienne, France.
| | - S Flori
- EA SNA-Epis 4607, université Jean-Monnet, 42023 Saint-Étienne, France
| | - V Pichot
- EA SNA-Epis 4607, université Jean-Monnet, 42023 Saint-Étienne, France
| | - J-C Barthelemy
- EA SNA-Epis 4607, université Jean-Monnet, 42023 Saint-Étienne, France
| | - F Roche
- EA SNA-Epis 4607, université Jean-Monnet, 42023 Saint-Étienne, France
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Abstract
Human infancy has been studied as a platform for hypothesis and theory testing, as a major physiological and psychological adjustment, as an object of adults' effects as well as a source of effects on adults, for its comparative value, as a stage of life, and as a setting point for the life course. Following an orientation to infancy studies, including previous reviews and a discussion of the special challenges infants pose to research, this article focuses on infancy as a foundation and catalyst of human development in the balance of the life course. Studies of stability and prediction from infancy illustrate the depth and complexity of modern research on infants and provide a long-awaited reply to key philosophical and practical questions about the meaningfulness and significance of infancy.
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Affiliation(s)
- Marc H Bornstein
- Child and Family Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Public Health Service, Bethesda, Maryland 20892;
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Rakow A, Katz-Salamon M, Ericson M, Edner A, Vanpée M. Decreased heart rate variability in children born with low birth weight. Pediatr Res 2013; 74:339-43. [PMID: 23770921 DOI: 10.1038/pr.2013.97] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2012] [Accepted: 01/07/2013] [Indexed: 11/09/2022]
Abstract
BACKGROUND Low birth weight (LBW) is associated with cardiovascular morbidity in adulthood. Imbalance in the autonomic nervous system (ANS) has been implicated as a mechanism behind the developmental programming of cardiovascular function. We hypothesized that deviations in the ANS function are seen in children born with LBW. METHODS Eighty-six children were included: 31 born preterm (<32 wk gestational age), 27 born at term but small for gestational age (SGA), and 28 born at term with normal birth weight (control). Twenty-four-hour Holter-electrocardiogram monitoring was performed at an average age of 9 y. Heart rate variability results were analyzed using frequency and time domain methods. RESULTS All frequency components and both time domain parameters tested were significantly lower in the preterm and SGA children compared with controls. The low frequency/high frequency ratio was not significantly different between children born with LBW and controls. CONCLUSION The autonomic control appears to be affected in children born with LBW despite gestational age at birth. Decreased total power, as an estimation of the ANS's global activity, rather than the balance between parasympathetic and sympathetic modulation might be an early marker of cardiovascular disease later on in life for LBW born children.
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Affiliation(s)
- Alexander Rakow
- Department of Woman and Child Health, Karolinska Institutet, Stockholm, Sweden.
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Hambleton MT, Reynolds EW, Sithisarn T, Traxel SJ, Patwardhan AR, Crawford TN, Mendiondo MS, Bada HS. Autonomic nervous system function following prenatal opiate exposure. Front Pediatr 2013; 1:27. [PMID: 24400273 PMCID: PMC3864192 DOI: 10.3389/fped.2013.00027] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2013] [Accepted: 09/27/2013] [Indexed: 11/13/2022] Open
Abstract
In utero exposure to opiates may affect autonomic functioning of the fetus and newborn. We investigated heart rate variability (HRV) as a measure of autonomic stability in prenatal opiate-exposed neonates (n = 14) and in control term infants (n = 10). Electrocardiographic data during both non-nutritive and nutritive sucking were evaluated for RR intervals, heart rate (HR), standard deviation of the consecutive RR intervals (SDRR), standard deviation of the differences of consecutive RR intervals (SDDRR), and the power spectral densities in low and high frequency bands. In controls, mean HR increased significantly, 143-161 per min (p = 0.002), with a trend toward a decrease in RR intervals from non-nutritive to nutritive sucking; these measures did not change significantly among exposed infants. Compared to controls, exposed infants demonstrated significantly greater HRV or greater mean SDRR and SDDRR during non-nutritive period (p < 0.01), greater mean SDDRR during nutritive sucking (p = 0.02), and higher powers in the low and high frequency bands during nutritive feedings. Our findings suggest that prenatal opiate exposure may be associated with changes in autonomic nervous system (ANS) functioning involving both sympathetic and parasympathetic branches. Future studies are needed to examine the effects of prenatal opiate exposure on ANS function.
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Affiliation(s)
| | - Eric W Reynolds
- Department of Pediatrics, University of Kentucky , Lexington, KY , USA
| | | | - Stuart J Traxel
- Department of Biomedical Engineering, University of Kentucky , Lexington, KY , USA
| | - Abhijit R Patwardhan
- Department of Biomedical Engineering, University of Kentucky , Lexington, KY , USA
| | - Timothy N Crawford
- Department of Biostatistics, College of Public Health, University of Kentucky , Lexington, KY , USA
| | - Marta S Mendiondo
- Department of Biostatistics, College of Public Health, University of Kentucky , Lexington, KY , USA
| | - Henrietta S Bada
- Department of Pediatrics, University of Kentucky , Lexington, KY , USA
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Moraes ER, Murta LO, Baffa O, Wakai RT, Comani S. Linear and nonlinear measures of fetal heart rate patterns evaluated on very short fetal magnetocardiograms. Physiol Meas 2012; 33:1563-83. [PMID: 22945491 DOI: 10.1088/0967-3334/33/10/1563] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
We analyzed the effectiveness of linear short- and long-term variability time domain parameters, an index of sympatho-vagal balance (SDNN/RMSSD) and entropy in differentiating fetal heart rate patterns (fHRPs) on the fetal heart rate (fHR) series of 5, 3 and 2 min duration reconstructed from 46 fetal magnetocardiograms. Gestational age (GA) varied from 21 to 38 weeks. FHRPs were classified based on the fHR standard deviation. In sleep states, we observed that vagal influence increased with GA, and entropy significantly increased (decreased) with GA (SDNN/RMSSD), demonstrating that a prevalence of vagal activity with autonomous nervous system maturation may be associated with increased sleep state complexity. In active wakefulness, we observed a significant negative (positive) correlation of short-term (long-term) variability parameters with SDNN/RMSSD. ANOVA statistics demonstrated that long-term irregularity and standard deviation of normal-to-normal beat intervals (SDNN) best differentiated among fHRPs. Our results confirm that short- and long-term variability parameters are useful to differentiate between quiet and active states, and that entropy improves the characterization of sleep states. All measures differentiated fHRPs more effectively on very short HR series, as a result of the fMCG high temporal resolution and of the intrinsic timescales of the events that originate the different fHRPs.
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Affiliation(s)
- Eder Rezende Moraes
- Departmento de Fisica e Matemática, FFCLRP-Universidade de São Paulo. Av. Bandeirantes, 3900, CEP 14040-901, Ribeirão Preto-SP, Brazil
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Rueda-Clausen CF, Morton JS, Dolinsky VW, Dyck JRB, Davidge ST. Synergistic effects of prenatal hypoxia and postnatal high-fat diet in the development of cardiovascular pathology in young rats. Am J Physiol Regul Integr Comp Physiol 2012; 303:R418-26. [PMID: 22739349 DOI: 10.1152/ajpregu.00148.2012] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
We have previously shown that adult offspring exposed to a prenatal hypoxic insult leading to intrauterine growth restriction (IUGR) are more susceptible to cardiovascular pathologies. Our objectives were to evaluate the interaction between hypoxia-induced IUGR and postnatal diet in the early development of cardiovascular pathologies. Furthermore, we sought to determine whether the postnatal administration of resveratrol could prevent the development of cardiovascular disorders associated with hypoxia-induced IUGR. On day 15 of pregnancy, Sprague-Dawley rats were randomly assigned to hypoxia (11.5% oxygen), to induce IUGR, or normal oxygen (control) groups. For study A, male offspring (3 wk of age) were randomly assigned a low-fat (LF, <10% fat) or a high-fat (HF, 45% fat) diet. For study B, offspring were randomized to either HF or HF+resveratrol diets. After 9 wk, cardiac and vascular functions were evaluated. Prenatal hypoxia and HF diet were associated with an increased myocardial susceptibility to ischemia. Blood pressure, in vivo cardiac function, and ex vivo vascular function were not different among experimental groups; however, hypoxia-induced IUGR offspring had lower resting heart rates. Our results suggest that prenatal insults can enhance the susceptibility to a second hit such as myocardial ischemia, and that this phenomenon is exacerbated, in the early stages of life by nutritional stressors such as a HF diet. Supplementing HF diets with resveratrol improved cardiac tolerance to ischemia in offspring born IUGR but not in controls. Thus we conclude that the additive effect of prenatal (hypoxia-induced IUGR) and postnatal (HF diet) factors can lead to the earlier development of cardiovascular pathology in rats, and postnatal resveratrol supplementation prevented the deleterious cardiovascular effects of HF diet in offspring exposed to prenatal hypoxia.
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