1
|
Vidigal GDP, Gonzaga LA, Porto AA, Garner DM, Cardoso VF, Valenti VE. A systematic review to investigate whether birth weight affects the autonomic nervous system in adulthood. REVISTA PAULISTA DE PEDIATRIA : ORGAO OFICIAL DA SOCIEDADE DE PEDIATRIA DE SAO PAULO 2023; 42:e2023002. [PMID: 37937677 PMCID: PMC10627483 DOI: 10.1590/1984-0462/2024/42/2023002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 07/03/2023] [Indexed: 11/09/2023]
Abstract
OBJECTIVE To evaluate the relationship between birth weight and the autonomic nervous system in adulthood through a systematic review. DATA SOURCE This is a systematic review of publications without limitation of year and language. We included studies involving the autonomic nervous system and birth weight in adults. Manuscripts were selected based on electronic searches of Medical Literature Analysis and Retrieval System Online (MEDLINE), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Science Cochrane Library and Scopus databases, using "Autonomic Nervous System" OR "Heart Rate" OR "Heart Rate Variability" AND "Birth Weight" as a search strategy. This review is registered on the International Prospective Register of Systematic Reviews - PROSPERO (ID: CRD42020165622). DATA SYNTHESIS We found 894 articles; 215 were excluded for duplicity. Of the remaining 679 studies, 11 remained. Two were excluded because they did not specifically treat the autonomic nervous system or birth weight. There were nine publications, two cohort and seven cross-sectional studies. The main findings were that extreme, very low, low or high birth weight may have some impact on the autonomic nervous system in adult life. CONCLUSIONS Birth weight outside the normality rate may have a negative influence on the autonomic nervous system, causing autonomic dysfunction and increasing the risk of cardiovascular diseases in adult life. Thus, the importance of the follow-up of health professionals from pregnancy to gestation and throughout life, with preventive care being emphasized.
Collapse
|
2
|
Schmidt LA, Poole KL, Krzeczkowski J, Van Lieshout RJ, Saigal S, Mathewson KJ. Long‐term stability of frontal electroencephalogram alpha power and asymmetry at rest in adults born at extremely low or normal birth weight: A 10‐year longitudinal study. Dev Psychobiol 2022; 64:e22256. [DOI: 10.1002/dev.22256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 12/30/2021] [Accepted: 01/23/2022] [Indexed: 11/10/2022]
Affiliation(s)
- Louis A. Schmidt
- Department of Psychology, Neuroscience & Behaviour McMaster University Hamilton Ontario Canada
| | - Kristie L. Poole
- Department of Psychology, Neuroscience & Behaviour McMaster University Hamilton Ontario Canada
| | - John Krzeczkowski
- Department of Psychiatry and Behaviour Neurosciences McMaster University Hamilton Ontario Canada
| | - Ryan J. Van Lieshout
- Department of Psychiatry and Behaviour Neurosciences McMaster University Hamilton Ontario Canada
| | - Saroj Saigal
- Department of Pediatrics McMaster University Hamilton Ontario Canada
| | - Karen J. Mathewson
- Department of Psychology, Neuroscience & Behaviour McMaster University Hamilton Ontario Canada
| |
Collapse
|
3
|
Mathewson KJ, McGowan PO, de Vega WC, Morrison KM, Saigal S, Van Lieshout RJ, Schmidt LA. Cumulative risks predict epigenetic age in adult survivors of extremely low birth weight. Dev Psychobiol 2021; 63 Suppl 1:e22222. [PMID: 34964497 DOI: 10.1002/dev.22222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Revised: 10/08/2021] [Accepted: 11/02/2021] [Indexed: 11/06/2022]
Abstract
Long-term sequelae of extremely low birth weight (ELBW; ≤1000 g) may contribute to accelerated biological aging. This hypothesis was examined by analyzing a range of risk factors with a molecular age marker in adults born at ELBW or normal birth weight (NBW; ≥2500 g). DNAm age-the weighted average of DNA methylation at 353 cytosine-phosphate-guanine (CpG) sites from across the genome-was derived from a sample of 45 ELBW (Mage = 32.35 years) and 47 NBW control (Mage = 32.44 years) adults, using the Illumina 850k BeadChip Array. At two assessments undertaken 9 years apart (at 23 and 32 years), cumulative risks were summed from six domains with potential to affect physiological and psychological health: resting respiratory sinus arrhythmia, blood pressure, basal cortisol, grip strength, body mass index, and self-esteem. At age 32 years, cumulative risks were differentially associated with epigenetic age in ELBW survivors (interaction, p < 0.01). For each additional risk factor they possessed, ELBW survivors (B = 1.43) were biologically 2.16 years older than NBW adults (B = -0.73), by the fourth decade of life. Developmental change, epigenetic maintenance, and intervention targets are discussed.
Collapse
Affiliation(s)
- Karen J Mathewson
- Department of Psychology, Neuroscience and Behaviour, McMaster University, Hamilton, Ontario, Canada
| | - Patrick O McGowan
- Department of Biological Sciences, Cell and Systems Biology, Psychology, and Physiology, University of Toronto, Toronto, Ontario, Canada
| | - Wilfred C de Vega
- Department of Biological Sciences, Cell and Systems Biology, Psychology, and Physiology, University of Toronto, Toronto, Ontario, Canada
| | | | - Saroj Saigal
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Ryan J Van Lieshout
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Louis A Schmidt
- Department of Psychology, Neuroscience and Behaviour, McMaster University, Hamilton, Ontario, Canada
| |
Collapse
|
4
|
Van Lieshout RJ, McGowan PO, de Vega WC, Savoy CD, Morrison KM, Saigal S, Mathewson KJ, Schmidt LA. Extremely Low Birth Weight and Accelerated Biological Aging. Pediatrics 2021; 147:peds.2020-001230. [PMID: 34001643 DOI: 10.1542/peds.2020-001230] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/08/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Extremely low birth weight (ELBW) (<1000 g) survivors are exposed to elevated levels of physiologic stress during their lives and may be susceptible to accelerated aging. Using the oldest known longitudinally followed cohort of ELBW survivors, we compared biological aging in this group using an epigenetic clock to a sample of matched normal birth weight (NBW) (>2500 g) control participants. METHODS Buccal cells were collected from 45 ELBW survivors and 49 NBW control participants at 30 to 35 years of age. Epigenetic age was calculated from the weighted average of DNA methylation at 353 cytosine-phosphate-guanine sequence within DNA sites, by using the Illumina Infinium Human Methylation EPIC 850k BeadChip array. RESULTS Before and after statistically adjusting for neurosensory impairment and the presence of chronic health conditions, a significant sex by birth weight group interaction was observed in the 353-site epigenetic-clock assay (P = .03), whereby ELBW men had a significantly older epigenetic age than NBW men (4.6 years; P = .01). Women born at ELBW were not found to be epigenetically older than their NBW peers. CONCLUSIONS The results of this study suggest that prenatal exposures may play an important role in aging, and that men born preterm may experience accelerated aging relative to their peers. We further highlight the need to monitor and promote the health of preterm survivors, with a particular focus on healthy aging across the life span.
Collapse
Affiliation(s)
| | - Patrick O McGowan
- Center for Environmental Epigenetics and Development, Department of Biological Sciences, University of Toronto Scarborough, Scarborough, Ontario, Canada
| | - Wilfred C de Vega
- Center for Environmental Epigenetics and Development, Department of Biological Sciences, University of Toronto Scarborough, Scarborough, Ontario, Canada
| | - Calan D Savoy
- Departments of Psychiatry and Behavioural Neurosciences,
| | | | | | - Karen J Mathewson
- Psychology, Neuroscience and Behaviour, McMaster University, Hamilton, Ontario; and
| | - Louis A Schmidt
- Psychology, Neuroscience and Behaviour, McMaster University, Hamilton, Ontario; and
| |
Collapse
|
5
|
Abstract
Adults who were born preterm are at increased risk of hypertension and cardiovascular disease in later life. Infants born late preterm are the majority of preterm births; however, the effect of late preterm on risk of cardiovascular disease is unclear. The objective of this study was to assess whether vascular health and cardiac autonomic control differ in a group of late preterm newborn infants compared to a group of term-born infants.A total of 35 healthy late preterm newborn infants, with normal growth (34-36 completed weeks' gestation) and 139 term-born infants (37-42 weeks' gestation) were compared in this study. Aortic wall thickening, assessed as aortic intima-media thickness (IMT) by high-resolution ultrasound, and cardiac autonomic control, assessed by heart rate variability, were measured during the first week of life. Postnatal age of full-term and late preterm infants at the time of the study was 5 days (standard deviation [SD] 5) and 4 days (SD 3), respectively.Infants born late preterm show reduced aortic IMT (574 μm [SD 51] vs. 612 μm [SD 73]) and reduced heart rate variability [log total power 622.3 (606.5) ms2 vs. 1180. 6 (1114.3) ms2], compared to term infants. These associations remained even after adjustment for sex and birth weight.Infants born late preterm show selective differences in markers of cardiovascular risk, with potentially beneficial differences in aortic wall thickness in contrast to potentially detrimental differences in autonomic control, when compared with term-born control infants. These findings provide pathophysiologic evidence to support an increased risk of hypertension and sudden cardiac death in individuals born late preterm.
Collapse
|
6
|
Extremely low birth weight influences the relationship between stress and telomere length in adulthood. J Dev Orig Health Dis 2020; 12:328-334. [PMID: 32468974 DOI: 10.1017/s2040174420000409] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
This study examined the link between two biological markers of stress vulnerability at 22-26 years of age and telomere length at 30-35 among extremely low birth weight (ELBW; <1000 g) survivors and normal birth weight (NBW; >2500 g) control participants. Sixteen ELBW and 22 NBW participants provided baseline afternoon salivary cortisol samples and resting frontal electroencephalogram (EEG) alpha asymmetry data at 22-26 years. Buccal cells were assayed for telomere length at 30-35 years. Analyses controlled for sex, postnatal steroid exposure, childhood socioeconomic status, time of cortisol sample collection, and body mass index at 22-26 years. Salivary cortisol and frontal asymmetry at age 22-26 independently predicted telomere length at age 30-35, such that relatively higher cortisol and greater relative right frontal asymmetry at rest predicted telomere shortening among NBW controls, but not among ELBW survivors. However, similar associations were not noted in ELBW survivors, suggesting that ELBW survivors may have different mechanisms of stress coping as a result of their early-life exposures. These findings offer preliminary evidence in support of the role of stress in the genesis of cellular senescence at least among those born at NBW, but that these links may differ in those born preterm.
Collapse
|
7
|
Messerli-Bürgy N, Meyer AH, Kakebeeke TH, Stülb K, Arhab A, Zysset AE, Leeger-Aschmann CS, Schmutz EA, Thayer JF, Groene M, Kriemler S, Jenni OG, Puder JJ, Munsch S. Cardiac vagal tone in preschool children: Interrelations and the role of stress exposure. Int J Psychophysiol 2020; 152:102-109. [PMID: 32302645 DOI: 10.1016/j.ijpsycho.2020.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 04/06/2020] [Accepted: 04/08/2020] [Indexed: 10/24/2022]
Abstract
INTRODUCTION Cardiac vagal tone has been understood as the biological correlate of emotion regulation and can be divided into emotion regulation (tonic cardiac vagal tone (TCVT)) and the flexibility to adapt to changing conditions (phasic cardiac vagal tone (PCVT)). There is evidence that TCVT influences PCVT dynamics in adults and that stress exposure impacts on cardiac vagal tone in adults and older children. The aim of the study was to investigate the impact of TCVT on PCVT dynamics in preschoolers and to identify the influence of stress exposures on cardiac vagal tone. METHOD Measures of heart rate variability including baseline (TCVT), during an age-adapted stress task (PCVT stress reactivity) and during recovery (PCVT recovery) were assessed in 222 children aged 2-6 years of the SPLASHY study. Further, parents were asked to complete questionnaires on early stress exposure (including pregnancy, birth and early life) and current stress exposure (including family stress and parenting). RESULTS Preschool children with high TCVT showed less PCVT reactivity (p < 0.001) and more increase of vagal tone (PCVT) during early recovery (p = 0.016). Further only child's low birth weight was a relevant stress exposure impacting on early and late PCVT recovery (p = 0.03/p = 0.005). None of the other early or late stress exposure conditions, nor the accumulation of stress exposures influenced TCVT or PCVT dynamics in these healthy preschoolers. DISCUSSION TCVT impacts on PCVT dynamics in a lab-based stress task in healthy preschool children and only low birth weight is related to more change during early and to less late PCVT recovery.
Collapse
Affiliation(s)
- Nadine Messerli-Bürgy
- Clinical Child Psychology & Biological Psychology, Department of Psychology, University of Fribourg, Fribourg, Switzerland.
| | - Andrea H Meyer
- Clinical Psychology and Psychotherapy, Department of Psychology, University of Fribourg, Fribourg, Switzerland; Department for Psychology, University of Basel, Basel, Switzerland.
| | - Tanja H Kakebeeke
- Child Development Center, University Children's Hospital Zurich, Zurich, Switzerland; Children's Research Center, University Children's Hospital Zurich, Zurich, Switzerland.
| | - Kerstin Stülb
- Clinical Psychology and Psychotherapy, Department of Psychology, University of Fribourg, Fribourg, Switzerland.
| | - Amar Arhab
- Obstetric Service, Department Women-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland.
| | - Annina E Zysset
- Child Development Center, University Children's Hospital Zurich, Zurich, Switzerland.
| | | | - Einat A Schmutz
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland.
| | - Julian F Thayer
- Department of Psychological Science, Social and Behavioral Sciences Gateway, University of California, Irvine, United States.
| | - Mareike Groene
- Clinical Child Psychology & Biological Psychology, Department of Psychology, University of Fribourg, Fribourg, Switzerland.
| | - Susi Kriemler
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland.
| | - Oskar G Jenni
- Child Development Center, University Children's Hospital Zurich, Zurich, Switzerland; Children's Research Center, University Children's Hospital Zurich, Zurich, Switzerland.
| | - Jardena J Puder
- Obstetric Service, Department Women-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland.
| | - Simone Munsch
- Clinical Psychology and Psychotherapy, Department of Psychology, University of Fribourg, Fribourg, Switzerland.
| |
Collapse
|
8
|
Yuan Y, Ali MK, Mathewson KJ, Sharma K, Faiyaz M, Tan W, Parsons SP, Zhang KK, Milkova N, Liu L, Ratcliffe E, Armstrong D, Schmidt LA, Chen JH, Huizinga JD. Associations Between Colonic Motor Patterns and Autonomic Nervous System Activity Assessed by High-Resolution Manometry and Concurrent Heart Rate Variability. Front Neurosci 2020; 13:1447. [PMID: 32038145 PMCID: PMC6989554 DOI: 10.3389/fnins.2019.01447] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Accepted: 12/27/2019] [Indexed: 12/12/2022] Open
Abstract
Abnormal colonic motility may be associated with dysfunction of the autonomic nervous system (ANS). Our aim was to evaluate if associations between colonic motor patterns and autonomic neural activity could be demonstrated by assessing changes in heart rate variability (HRV) in healthy volunteers. A total of 145 colonic motor patterns were assessed in 11 healthy volunteers by High-Resolution Colonic Manometry (HRCM) using an 84-channel water-perfused catheter. Motor patterns were evoked by balloon distention, a meal and luminal bisacodyl. The electrocardiogram (ECG) and cardiac impedance were assessed during colonic manometry. Respiratory sinus arrhythmia (RSA) and root mean square of successive differences of beat-to-beat intervals (RMSSD) served as measures of parasympathetic reactivity while the Baevsky's Stress Index (SI) and the pre-ejection period (PEP) were used as measures of sympathetic reactivity. Taking all motor patterns into account, our data show that colonic motor patterns are accompanied by increased parasympathetic activity and decreased sympathetic activity that may occur without eliciting a significant change in heart rate. Motor Complexes (more than one motor pattern occurring in close proximity), High-Amplitude Propagating Pressure Waves followed by Simultaneous Pressure Waves (HAPW-SPWs) and HAPWs without SPWs are all associated with an increase in RSA and a decrease in SI. Hence RSA and SI may best reflect autonomic activity in the colon during these motor patterns as compared to RMSSD and PEP. SI and PEP do not measure identical sympathetic reactivity. The SPW, which is a very low amplitude pressure wave, did not significantly change the autonomic measures employed here. In conclusion, colonic motor patterns are associated with activity in the ANS which is reflected in autonomic measures of heart rate variability. These autonomic measures may serve as proxies for autonomic neural dysfunction in patients with colonic dysmotility.
Collapse
Affiliation(s)
- Yuhong Yuan
- Department of Gastroenterology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.,Department of Medicine, Division of Gastroenterology, Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, ON, Canada
| | - M Khawar Ali
- Department of Medicine, Division of Gastroenterology, Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, ON, Canada.,School of Biomedical Engineering, McMaster University, Hamilton, ON, Canada
| | - Karen J Mathewson
- Department of Psychology, Neuroscience, and Behaviour, McMaster University, Hamilton, ON, Canada
| | - Kartik Sharma
- Department of Medicine, Division of Gastroenterology, Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, ON, Canada
| | - Mahi Faiyaz
- Department of Medicine, Division of Gastroenterology, Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, ON, Canada
| | - Wei Tan
- Department of Medicine, Division of Gastroenterology, Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, ON, Canada.,Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Sean P Parsons
- Department of Medicine, Division of Gastroenterology, Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, ON, Canada
| | - Kailai K Zhang
- Department of Medicine, Division of Gastroenterology, Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, ON, Canada
| | - Natalija Milkova
- Department of Medicine, Division of Gastroenterology, Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, ON, Canada
| | - Lijun Liu
- Department of Medicine, Division of Gastroenterology, Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, ON, Canada
| | - Elyanne Ratcliffe
- Department of Pediatrics, Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, ON, Canada
| | - David Armstrong
- Department of Medicine, Division of Gastroenterology, Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, ON, Canada
| | - Louis A Schmidt
- Department of Psychology, Neuroscience, and Behaviour, McMaster University, Hamilton, ON, Canada
| | - Ji-Hong Chen
- Department of Medicine, Division of Gastroenterology, Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, ON, Canada
| | - Jan D Huizinga
- Department of Medicine, Division of Gastroenterology, Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, ON, Canada.,School of Biomedical Engineering, McMaster University, Hamilton, ON, Canada
| |
Collapse
|
9
|
Karvonen R, Sipola M, Kiviniemi AM, Tikanmäki M, Järvelin MR, Eriksson JG, Tulppo MP, Vääräsmäki M, Kajantie E. Postexercise Heart Rate Recovery in Adults Born Preterm. J Pediatr 2019; 214:89-95.e3. [PMID: 31399247 DOI: 10.1016/j.jpeds.2019.06.056] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 05/15/2019] [Accepted: 06/24/2019] [Indexed: 01/30/2023]
Abstract
OBJECTIVE To evaluate postexercise heart rate recovery (HRR) in adults born preterm. STUDY DESIGN We studied the association between preterm birth and postexercise HRR in 545 adults (267 women) at 23.3 years of age (range 19.9-26.3 years). One hundred three participants were born early preterm (<34 completed weeks), 178 late preterm (34-36), and 264 were full term (control group). HRR was calculated as change in heart rate (HR) 30 seconds and 60 seconds after cessation of submaximal step test and maximum HR slope during the first minute after. RESULTS Mean peak HR was 159.5 bpm in the early preterm (P = .16 with controls), 157.8 bpm in the late preterm (P = .56), and 157.0 bpm in the control group. Mean HRR 30 seconds after exercise was 3.2 bpm (95% CI 1.1-5.2) lower in the early preterm group and 2.1 bpm (0.3-3.8) lower in the late preterm group than the full term controls. Mean 60s HRR was 2.5 (-0.1 to 5.1) lower in the early preterm group and 2.8 bpm (0.6-4.9) lower in the late preterm group. Mean maximum slope after exercise was 0.10 beats/s (0.02-0.17) lower in the early preterm group and 0.06 beats/s (0.00-0.12) lower in the late preterm group. CONCLUSIONS Our results suggest reduced HRR after exercise in adults born preterm, including those born late preterm. This suggests altered reactivation of the parasympathetic nervous system, which may contribute to cardiovascular risk among adults born preterm.
Collapse
Affiliation(s)
- Risto Karvonen
- Department of Chronic Disease Prevention, National Institute for Health and Welfare, Oulu and Helsinki, Finland; PEDEGO Research Unit, Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland.
| | - Marika Sipola
- Department of Chronic Disease Prevention, National Institute for Health and Welfare, Oulu and Helsinki, Finland; PEDEGO Research Unit, Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - Antti M Kiviniemi
- Research Unit of Internal Medicine, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Marjaana Tikanmäki
- Department of Chronic Disease Prevention, National Institute for Health and Welfare, Oulu and Helsinki, Finland; PEDEGO Research Unit, Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - Marjo-Riitta Järvelin
- Department of Children and Families, National Institute for Health and Welfare, Oulu and Helsinki, Finland; Biocenter Oulu, Oulu, Finland; Unit of Primary Care Unit, Oulu, Finland; Department of Epidemiology and Biostatistics, Imperial College London, MRC Health Protection Agency (HPA) Centre for Environment and Health, School of Public Health, London, United Kingdom
| | - Johan G Eriksson
- Department of Chronic Disease Prevention, National Institute for Health and Welfare, Oulu and Helsinki, Finland; Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Mikko P Tulppo
- Research Unit of Internal Medicine, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Marja Vääräsmäki
- Department of Children and Families, National Institute for Health and Welfare, Oulu and Helsinki, Finland; PEDEGO Research Unit, Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland; Research Unit of Internal Medicine, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Eero Kajantie
- Department of Chronic Disease Prevention, National Institute for Health and Welfare, Oulu and Helsinki, Finland; PEDEGO Research Unit, Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland; Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway; Children's Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| |
Collapse
|
10
|
Karvonen R, Sipola M, Kiviniemi A, Tikanmäki M, Järvelin MR, Eriksson JG, Tulppo M, Vääräsmäki M, Kajantie E. Cardiac Autonomic Function in Adults Born Preterm. J Pediatr 2019; 208:96-103.e4. [PMID: 30732997 DOI: 10.1016/j.jpeds.2018.12.061] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Revised: 12/07/2018] [Accepted: 12/31/2018] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To evaluate cardiac autonomic function in adults born preterm. STUDY DESIGN We studied the association between prematurity and cardiac autonomic function using heart rate variability measurements in 600 adults (mean age of 23.3 years) from a geographically based cohort in Northern Finland. There were 117 young adults born early preterm (<34 weeks), 207 born late preterm (34-36 weeks), and 276 born at term (≥37 weeks, controls). Autonomic function was analyzed by calculating time and frequency domain heart rate variability measurements using linear regression. RESULTS Compared with controls, the mean difference in root mean square of successive differences (indicating cardiac vagal activity) was -12.0% (95% CI -22.2%, -0.5%, adjusted for sex, age, source cohort, and season P = .04) for the early preterm group and -7.8% (-16.8%, 2.0%, P = .12) for the late preterm group. Mean differences with controls in low frequency power (indicating cardiac vagal activity, including some sympathetic- and baroreflex-mediated effects) were -13.6% (-26.7%, 1.8%, P = .08) for the early preterm group and -16.4% (-27.0%, -4.3%, P = .01) for the late preterm group. Mean differences in high frequency power (quantifying cardiac vagal modulation in respiratory frequency) were -19.2% (-36.6%, 2.9%, P = .09) for the early preterm group and -13.8% (-29.4%, 5.3%, P = .15) for the late preterm group. Differences were attenuated when controlled for body mass index and physical activity. CONCLUSIONS Our results suggest altered autonomic regulatory control in adults born preterm, including those born late preterm. Altered autonomic regulatory control may contribute to increased cardiovascular risk in adults born preterm.
Collapse
Affiliation(s)
- Risto Karvonen
- Department of Chronic Disease Prevention, National Institute for Health and Welfare, Oulu and Helsinki, Finland; Research Unit for Pediatrics, Pediatric Neurology, Pediatric Surgery, Child Psychiatry, Dermatology, Clinical Genetics, Obstetrics and Gynecology, Otorhinolaryngology and Ophthalmology (PEDEGO), Medical Research Center Oulu, University of Oulu, Oulu, Finland.
| | - Marika Sipola
- Department of Chronic Disease Prevention, National Institute for Health and Welfare, Oulu and Helsinki, Finland; Research Unit for Pediatrics, Pediatric Neurology, Pediatric Surgery, Child Psychiatry, Dermatology, Clinical Genetics, Obstetrics and Gynecology, Otorhinolaryngology and Ophthalmology (PEDEGO), Medical Research Center Oulu, University of Oulu, Oulu, Finland; Institute of Health Sciences, Helsinki University Hospital and University of Helsinki, Helsinki, Finland; Department of Pediatrics and Adolescence, Oulu University Hospital, Oulu, Finland
| | - Antti Kiviniemi
- Research Unit of Internal Medicine, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Marjaana Tikanmäki
- Department of Chronic Disease Prevention, National Institute for Health and Welfare, Oulu and Helsinki, Finland; Research Unit for Pediatrics, Pediatric Neurology, Pediatric Surgery, Child Psychiatry, Dermatology, Clinical Genetics, Obstetrics and Gynecology, Otorhinolaryngology and Ophthalmology (PEDEGO), Medical Research Center Oulu, University of Oulu, Oulu, Finland; Institute of Health Sciences, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Marjo-Riitta Järvelin
- Institute of Health Sciences, Helsinki University Hospital and University of Helsinki, Helsinki, Finland; Department of Children and Families, Oulu and Helsinki, Finland; Biocenter Oulu, Oulu, Finland; Unit of Primary Care Unit, Oulu, Finland; Department of Epidemiology and Biostatistics, Imperial College London, Medical Research Council Health Protection Agency Center for Environment and Health, School of Public Health, London, United Kingdom
| | - Johan G Eriksson
- Department of General Practice and Primary Health Care, Helsinki, Finland; Folkhälsan Research Center, Helsinki, Finland
| | - Mikko Tulppo
- Research Unit of Internal Medicine, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Marja Vääräsmäki
- Research Unit for Pediatrics, Pediatric Neurology, Pediatric Surgery, Child Psychiatry, Dermatology, Clinical Genetics, Obstetrics and Gynecology, Otorhinolaryngology and Ophthalmology (PEDEGO), Medical Research Center Oulu, University of Oulu, Oulu, Finland; Department of Children and Families, Oulu and Helsinki, Finland
| | - Eero Kajantie
- Department of Chronic Disease Prevention, National Institute for Health and Welfare, Oulu and Helsinki, Finland; Research Unit for Pediatrics, Pediatric Neurology, Pediatric Surgery, Child Psychiatry, Dermatology, Clinical Genetics, Obstetrics and Gynecology, Otorhinolaryngology and Ophthalmology (PEDEGO), Medical Research Center Oulu, University of Oulu, Oulu, Finland; Hospital of Children and Adolescents, Helsinki University Hospital and University of Helsinki, Helsinki, Finland; Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| |
Collapse
|
11
|
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.
Collapse
|
12
|
Souza LV, Oliveira V, De Meneck F, Grotti Clemente AP, Strufaldi MWL, Franco MDC. Birth Weight and Its Relationship with the Cardiac Autonomic Balance in Healthy Children. PLoS One 2017; 12:e0167328. [PMID: 28095501 PMCID: PMC5240907 DOI: 10.1371/journal.pone.0167328] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Accepted: 11/11/2016] [Indexed: 01/13/2023] Open
Abstract
Several studies indicate that the fetal environment plays a significant role in the development of cardiometabolic disease later in life. However, a few studies present conflicting data about the correlation between birth weight and the impairment of cardiac autonomic modulation. The purpose of the present study was to provide further knowledge to elucidate this contradictory relationship. One hundred children aged 5 and 14 years had anthropometric parameters, body composition and blood pressure levels determined. Heart rate variability (HRV) was evaluated by heart rate monitoring, including measurements of both the time and frequency domains. The results showed inverse correlation between the HRV parameters with BMI (RMSSD: P = 0.047; PNN50: P = 0.021; HF: P = 0.041), systolic (RMSSD: P = 0.023; PNN50: P = 0.032) and diastolic (PNN50: P = 0.030) blood pressure levels. On the other hand, there were consistent positive correlations between the HRV parameters and birth weight (RMSSD: P = 0.001; PNN50: P = 0.001; HF: P = 0.002). To determine the effect of birth weight on HRV parameters, we perform multivariate linear regression analysis adjusted for potentially confounding factors (prematurity, gender, age, BMI, physical activity index and SBP levels). These findings were preserved even after adjusting for these confounders. Our results suggested that impaired cardiac autonomic modulation characterized by a reduction in the parasympathetic activity occurs in children with low birth weight. One possible interpretation for these data is that a vagal withdrawal, rather than a sympathetic overactivity, could precede the development of hypertension and other cardiometabolic diseases in children with low birth weight. However, long-term studies should be performed to investigate this possibility.
Collapse
Affiliation(s)
| | - Vanessa Oliveira
- Nephrology Division, Federal University of São Paulo, São Paulo, Brazil
| | | | | | | | | |
Collapse
|