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Helánová K, Šišáková M, Hnatkova K, Novotný T, Andršová I, Malik M. Development of autonomic heart rate modulations during childhood and adolescence. Pflugers Arch 2024; 476:1187-1207. [PMID: 38937370 PMCID: PMC11271370 DOI: 10.1007/s00424-024-02979-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Revised: 05/05/2024] [Accepted: 06/10/2024] [Indexed: 06/29/2024]
Abstract
Autonomic control of heart rate is well known in adult subjects, but limited data are available on the development of the heart rate control during childhood and adolescence. Continuous 12-lead electrocardiograms were recorded in 1045 healthy children and adolescents (550 females) aged 4 to 19 years during postural manoeuvres involving repeated 10-min supine, unsupported sitting, and unsupported standing positions. In each position, heart rate was measured, and heart rate variability indices were evaluated (SDNN, RMSSD, and high (HF) and low (LF) frequency components were obtained). Quasi-normalized HF frequency components were defined as qnHF = HF/(HF + LF). These measurements were, among others, related to age using linear regressions. In supine position, heart rate decreases per year of age were significant in both sexes but lower in females than in males. In standing position, these decreases per year of age were substantially lowered. RMSSD and qnHF indices were independent of age in supine position but significantly decreased with age in sitting and standing positions. Correspondingly, LF/HF proportions showed steep increases with age in sitting and standing positions but not in the supine position. The study suggests that baseline supine parasympathetic influence shows little developmental changes during childhood and adolescence but that in young children, sympathetic branch is less responsive to vagal influence. While vagal influences modulate cardiac periods in young and older children equally, they are less able to suppress the sympathetic influence in younger children.
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Affiliation(s)
- Kateřina Helánová
- Department of Internal Medicine and Cardiology, University Hospital Brno, Jihlavská 20, 625 00, Brno, Czech Republic
- Department of Internal Medicine and Cardiology, Faculty of Medicine, Masaryk University, Jihlavská 20, 625 00, Brno, Czech Republic
| | - Martina Šišáková
- Department of Internal Medicine and Cardiology, University Hospital Brno, Jihlavská 20, 625 00, Brno, Czech Republic.
- Department of Internal Medicine and Cardiology, Faculty of Medicine, Masaryk University, Jihlavská 20, 625 00, Brno, Czech Republic.
| | - Katerina Hnatkova
- National Heart and Lung Institute, Imperial College, 72 Du Cane Rd, Shepherd's Bush, London, W12 0NN, England
| | - Tomáš Novotný
- Department of Internal Medicine and Cardiology, University Hospital Brno, Jihlavská 20, 625 00, Brno, Czech Republic
- Department of Internal Medicine and Cardiology, Faculty of Medicine, Masaryk University, Jihlavská 20, 625 00, Brno, Czech Republic
| | - Irena Andršová
- Department of Internal Medicine and Cardiology, University Hospital Brno, Jihlavská 20, 625 00, Brno, Czech Republic
- Department of Internal Medicine and Cardiology, Faculty of Medicine, Masaryk University, Jihlavská 20, 625 00, Brno, Czech Republic
| | - Marek Malik
- Department of Internal Medicine and Cardiology, Faculty of Medicine, Masaryk University, Jihlavská 20, 625 00, Brno, Czech Republic
- National Heart and Lung Institute, Imperial College, 72 Du Cane Rd, Shepherd's Bush, London, W12 0NN, England
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Šišáková M, Helánová K, Hnatkova K, Andršová I, Novotný T, Malik M. Intra-Individual Relationship between Heart Rate Variability and the Underlying Heart Rate in Children and Adolescents. J Clin Med 2024; 13:2897. [PMID: 38792438 PMCID: PMC11121958 DOI: 10.3390/jcm13102897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 04/20/2024] [Accepted: 05/11/2024] [Indexed: 05/26/2024] Open
Abstract
Background/Objective: The relationship between heart rate and heart rate variability (HRV) indices has been repeatedly studied in adults but limited data are available on the relationship in paediatric populations. Methods: Continuous 12-lead electrocardiograms were recorded in 1016 healthy children and adolescents (534 females) aged 4 to 19 years during postural manoeuvres with rapid changes between 10-min positions of supine → sitting → standing → supine → standing → sitting → supine. In each position, the averaged RR interval was measured together with four HRV indices, namely the SDNN, RMSSD, quasi-normalised high-frequency components (qnHF), and the proportions of low- and high-frequency components (LF/HF). In each subject, the slope of the linear regression between the repeated HRV measurements and the corresponding RR interval averages was calculated. Results: The intra-subject regression slopes, including their confidence intervals, were related to the age and sex of the subjects. The SDNN/RR, RMSSD/RR, and qnHF/RR slopes were significantly steeper (p < 0.001) and the (LF/HF)/RR slopes were significantly shallower (p < 0.001) in younger children compared to older children and adolescents. Conclusions: The study suggests that sympathetic and vagal influences on heart rate are present in both younger and older children. With advancing age, the sympatho-vagal balance gradually develops and allows the vagal control to suppress the sympathetic drive towards higher heart rates seen in younger age children.
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Affiliation(s)
- Martina Šišáková
- Department of Internal Medicine and Cardiology, University Hospital Brno, Jihlavská 20, 625 00 Brno, Czech Republic; (M.Š.); (I.A.)
- Department of Internal Medicine and Cardiology, Faculty of Medicine, Masaryk University, 62 500 Brno, Czech Republic
| | - Kateřina Helánová
- Department of Internal Medicine and Cardiology, University Hospital Brno, Jihlavská 20, 625 00 Brno, Czech Republic; (M.Š.); (I.A.)
- Department of Internal Medicine and Cardiology, Faculty of Medicine, Masaryk University, 62 500 Brno, Czech Republic
| | - Katerina Hnatkova
- National Heart and Lung Institute, Imperial College, London SW3 6LY, UK; (K.H.); (M.M.)
| | - Irena Andršová
- Department of Internal Medicine and Cardiology, University Hospital Brno, Jihlavská 20, 625 00 Brno, Czech Republic; (M.Š.); (I.A.)
- Department of Internal Medicine and Cardiology, Faculty of Medicine, Masaryk University, 62 500 Brno, Czech Republic
| | - Tomáš Novotný
- Department of Internal Medicine and Cardiology, University Hospital Brno, Jihlavská 20, 625 00 Brno, Czech Republic; (M.Š.); (I.A.)
- Department of Internal Medicine and Cardiology, Faculty of Medicine, Masaryk University, 62 500 Brno, Czech Republic
| | - Marek Malik
- Department of Internal Medicine and Cardiology, Faculty of Medicine, Masaryk University, 62 500 Brno, Czech Republic
- National Heart and Lung Institute, Imperial College, London SW3 6LY, UK; (K.H.); (M.M.)
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Chen H, Xu J, Xie H, Huang Y, Shen X, Xu F. Effects of physical activity on heart rate variability in children and adolescents: a systematic review and meta-analysis. CIENCIA & SAUDE COLETIVA 2022; 27:1827-1842. [PMID: 35544812 DOI: 10.1590/1413-81232022275.10402021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 07/27/2021] [Indexed: 12/24/2022] Open
Abstract
The aim of the study was to investigate the effects of physical activity (PA) on heart rate variability (HRV) in children and adolescents. We conducted a research of Web of Science, PubMed, ScienceDirect, Springer-Link and EBSCO-host. The revised Newcastle-Ottawa Scale was used in an investigative analysis to assess bias risk. A total of 21 studies were included. Overall, medium-sized associations were found between PA and low frequency and high frequency in children and adolescents. High PA level had significantly higher standard deviation of RR intervals and root of the mean of the sum of the squares of differences between adjacent RR intervals in children and adolescents. The effects of PA on HRV were consistent in children and adolescents. Our systematic review and meta-analysis revealed medium-sized between PA and HRV in children and adolescents. Promoting children's and adolescents' participation in moderate-to-vigorous physical activity (MVPA) will increase parasympathetic nerve activity and decreased sympathetic nerve activity. Our findings support motivating children and adolescents to engage in more MVPA in their daily lives to improve autonomic nervous system function and promote cardiovascular safety.
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Affiliation(s)
- Hao Chen
- School of Physical Education, Hangzhou Normal University. 311121 Hangzhou China.
| | - Jing Xu
- School of Physical Education, Hangzhou Normal University. 311121 Hangzhou China.
| | - Hao Xie
- Department of Physical Education, Zhejiang University of Finance & Economics. Hangzhou China
| | - Yufen Huang
- The Children's Hospital, Zhejiang University School of Medicine. Hangzhou China
| | - Xin Shen
- The Children's Hospital, Zhejiang University School of Medicine. Hangzhou China
| | - Fei Xu
- School of Physical Education, Hangzhou Normal University. 311121 Hangzhou China.
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Anthropometric Determinants of Respiratory Sinus Arrhythmia in Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19010566. [PMID: 35010824 PMCID: PMC8744931 DOI: 10.3390/ijerph19010566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 12/23/2021] [Accepted: 12/31/2021] [Indexed: 11/17/2022]
Abstract
Background: The study was conducted to investigate the implications of anthropometry in school-aged children on the degree of respiratory sinus arrhythmia observed in clinical settings. Methods: In a cohort study, 626 healthy children (52% male) aged 10.8 ± 0.5 years attending primary school in a single town underwent a 12-lead electrocardiogram coupled with measurements of height, weight and blood pressure. Indices of respiratory sinus arrhythmia (pvRSA, RMSSD, RMSSDc) were derived from semi-automatic measurements of RR intervals. Height, weight, BMI, blood pressure as well as waist and hip circumferences were compared between subjects with rhythmic heart rate and respiratory sinus arrhythmia, and correlations between indices of sinus arrhythmia and anthropometry were investigated. Results: Respiratory sinus arrhythmia was recognized in 43% of the participants. Subjects with sinus arrhythmia had lower heart rate (p < 0.001), weight (p = 0.009), BMI (p = 0.005) and systolic (p = 0.018) and diastolic (p = 0.004) blood pressure. There were important inverse correlations of heart rate and indices of sinus arrhythmia (r = −0.52 for pvRSA and r = −0.58 for RMSSD), but not the anthropometry. Conclusion: Lower prevalence of respiratory sinus arrhythmia among children with overweight and obesity is a result of higher resting heart rate observed in this population.
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Sitovskyi AM, Radchenko OV, Dmytruk VS, Andriichuk OY, Roda OB, Savchuk IV. Heart Rate Variability in 12- to 13-Year-Old Adolescents. NEUROPHYSIOLOGY+ 2021. [DOI: 10.1007/s11062-021-09883-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Peres CDS, Gava RP, Yoshida NM, Correa JCM, Scudeller LB, Seixas GF, Silva CC, Garbelini CCD, Ramos SDP. Could regular practice of volleyball modulate salivary secretory immunity in children? Cross-sectional and longitudinal studies. APUNTS SPORTS MEDICINE 2020. [DOI: 10.1016/j.apunsm.2020.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Speer KE, Naumovski N, Semple S, McKune AJ. Lifestyle Modification for Enhancing Autonomic Cardiac Regulation in Children: The Role of Exercise. CHILDREN-BASEL 2019; 6:children6110127. [PMID: 31744115 PMCID: PMC6915468 DOI: 10.3390/children6110127] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 11/05/2019] [Accepted: 11/15/2019] [Indexed: 12/20/2022]
Abstract
Decreased physical activity (PA) is a global concern contributing to the rise in cardiometabolic diseases. One potential mechanism linking insufficient PA and poor health is dysregulated autonomic nervous system (ANS) activity. This relationship is established in adults and PA recommendations, with specific exercise prescription guidelines, have been proposed to overcome this societal health burden. However, research on the benefits and underlying mechanisms of exercise on ANS activity in children <18 years old is limited. This review aimed to describe the optimal exercise “dose” and potential mechanisms of action that exercise may pose on enhancing child ANS activity, represented by heart rate variability (HRV). PubMed, Web of Science and Google Scholar were searched for articles examining the influence of exercise on child HRV. Various exercise duration and frequency combinations appear to improve HRV indices, primarily those representing parasympathetic influence. Furthermore, both aerobic and resistance training benefit HRV through potentially different mechanisms with intensity proposed to be important for exercise prescription. Findings indicate that exercise is a crucial lifestyle modification with protective and therapeutic effects on cardiometabolic health associated with improvements in child ANS activity. Exercise programming must consider the various components including mode, intensity and population characteristics to optimize ANS health.
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Affiliation(s)
- Kathryn E Speer
- Faculty of Health, Discipline of Sport and Exercise Science, University of Canberra, Canberra (ACT) 2617, Australia; (S.S.); (A.J.M.)
- Research Institute for Sport and Exercise Science, University of Canberra, Canberra (ACT) 2617, Australia
- Correspondence:
| | - Nenad Naumovski
- Faculty of Health, University of Canberra, Canberra (ACT) 2617, Australia;
| | - Stuart Semple
- Faculty of Health, Discipline of Sport and Exercise Science, University of Canberra, Canberra (ACT) 2617, Australia; (S.S.); (A.J.M.)
- Research Institute for Sport and Exercise Science, University of Canberra, Canberra (ACT) 2617, Australia
| | - Andrew J McKune
- Faculty of Health, Discipline of Sport and Exercise Science, University of Canberra, Canberra (ACT) 2617, Australia; (S.S.); (A.J.M.)
- Research Institute for Sport and Exercise Science, University of Canberra, Canberra (ACT) 2617, Australia
- Discipline of Biokinetics, Exercise and Leisure Sciences, School of Health Sciences, University of KwaZulu-Natal, Durban (KwaZulu-Natal) 4041, South Africa
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Park J, Park CH, Jun SE, Lee EJ, Kang SW, Kim N. Effects of biofeedback-based sleep improvement program on urinary symptoms and sleep patterns of elderly Korean women with overactive bladder syndrome. BMC Urol 2019; 19:109. [PMID: 31703581 PMCID: PMC6839159 DOI: 10.1186/s12894-019-0540-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2019] [Accepted: 10/20/2019] [Indexed: 11/29/2022] Open
Abstract
Background The prevalence of overactive bladder syndrome (OAB) increases with age. Sleep disturbances in elderly individuals with OAB is a common problem. The purpose of this study was to examine the effects of a biofeedback-based sleep improvement (BBSI) program on urinary symptoms and sleep patterns in elderly Korean women with OAB. Methods A non-equivalent control group pre−/post-test design was used. Elderly women with OAB were assigned to an intervention group (n = 20) or a control group (n = 18). The BBSI program was implemented in the intervention group for 12 weeks, while two educational sessions of general sleep hygiene and lifestyle modification were provided to the control group. Using SPSS 23.0, the data were analyzed by descriptive analysis using the chi-square test, Fisher’s exact test, Mann-Whitney test, and Wilcoxon test. Results After the 12-week BBSI program, significant improvements were found in the intervention group’s the square root of the mean squared differences of successive R-R intervals (p = 0.025), low frequency/high frequency ratio (p = 0.006), and epinephrine (p = 0.039). We also observed a significant difference in urinary symptoms, sleep efficiency, wake after sleep onset, number of awakenings, and number of awakenings within 3 h after sleep onset (p < 0.001, p = 0.004, p = 0.001, p = 0.001, and p = 0.048, respectively). However, no significant changes were found in these variables in the control group. Conclusions The BBSI program effectively improved urinary symptoms and sleep patterns of elderly Korean women with OAB. Further longitudinal research is required to investigate the sustainability and effects of the BBSI program. Trial registration KCT0003882. Date of registration: 02/05/2019. Retrospectively registered.
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Affiliation(s)
- Jooyeon Park
- College of Nursing, Keimyung University, Daegu, Republic of Korea
| | - Choal Hee Park
- Department of Urology, Keimyung University School of Medicine, Daegu, Republic of Korea
| | - Sang-Eun Jun
- College of Nursing, Keimyung University, Daegu, Republic of Korea
| | - Eun-Ju Lee
- College of Nursing, Keimyung University, Daegu, Republic of Korea
| | - Seung Wan Kang
- College of Nursing, Seoul National University, Seoul, Republic of Korea
| | - Nahyun Kim
- College of Nursing, Keimyung University, Daegu, Republic of Korea.
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Effects of 9 Months of Martial Arts Training on Cardiac Autonomic Modulation in Healthy Children and Adolescents. Pediatr Exerc Sci 2018; 30:487-494. [PMID: 30336749 DOI: 10.1123/pes.2017-0083] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
PURPOSE The aim of the study was to evaluate the cardiac autonomic modulation after 9 months of martial arts practice in healthy children and adolescents. METHOD The study included 59 children and adolescents who were divided into 3 groups: judo, Muay Thai, and control. Heart rate variability was measured by a heart rate monitor, model Polar RS800CX. The intervention occurred twice a week on nonconsecutive days, lasting 60 minutes each session. A 1-way analysis of variance was used to compare participants at baseline. The comparisons between groups at baseline and after the intervention were carried out by a 2-way analysis of variance for repeated measures. RESULTS After 9 months of intervention, significant increases were observed for root mean square successive differences, with higher values post compared with baseline (19.5%; P = .04). For SD1, an interaction effect was observed, with increased posttraining values compared with baseline (24.1%; P = .04) for the judo group. Qualitative analysis of the Poincaré plot showed greater dispersion of RR intervals, mainly beat to beat, after the judo intervention compared with the baseline. The Muay Thai and control groups presented no improvement. CONCLUSION After 9 months of intervention, there were increases in cardiac autonomic modulation of children and adolescents participating in judo training. The practice of martial arts, such as judo, can be encouraged from an early age to improve cardiovascular system functioning, possibly providing protection against cardiovascular problems.
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van Biljon A, McKune AJ, DuBose KD, Kolanisi U, Semple SJ. Short-Term High-Intensity Interval Training Is Superior to Moderate-Intensity Continuous Training in Improving Cardiac Autonomic Function in Children. Cardiology 2018; 141:1-8. [PMID: 30227396 DOI: 10.1159/000492457] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Accepted: 07/18/2018] [Indexed: 01/18/2023]
Abstract
OBJECTIVES This study aimed to investigate the impact of 3 isocaloric exercise programs on cardiac autonomic nervous system (ANS) functioning in children. METHODS One hundred nine children (39% boys and 61% girls) aged 10-13 years (mean 11.07 ± 0.81) were conveniently assigned to 1 of 4 groups as follows: Moderate-intensity continuous training (MICT; n = 29) at 65-70% of the predicted maximum heart rate (MHR), High-intensity interval training (HIIT; n = 29) at > 80% of the predicted MHR, HIIT and MICT combined on alternate weeks (ALT; n = 27), and a control group (n = 24). Morning ANS activity was assessed via analysis of heart rate variability (HRV), with the patient in supine position for 10 min, before and after the exercise intervention. DATA ANALYSIS A 2-way analysis of variance was used to evaluate the effects of training on all HRV parameters (p < 0.05/4 = 0.0125). RESULTS After 5 weeks of training, significant improvements were observed for ln of the standard deviation of normal-to-normal intervals (p < 0.0001), ln of the root mean square of successive difference (p < 0.0001), and ln of standard deviation 1 (p < 0.0001), with superior results reported in the HIIT group (effect size [ES] = 2.22, 2.69, and 2.69) compared with the MICT (ES = 1.67, 1.75, and 1.75) and ALT (ES = 0.87, 1.06, and 1.06) groups, respectively. CONCLUSION Short-term HIIT seems to induce superior alterations in cardiac ANS activity compared to MICT and ALT in children through enhanced vagal activity.
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Affiliation(s)
- Anneke van Biljon
- Department of Biokinetics and Sports Science, University of Zululand, KwaDlangezwa, South
| | - Andrew J McKune
- Discipline of Biokinetics, Exercise and Leisure Sciences, School of Health Sciences, University of KwaZulu-Natal, Durban, South Africa.,Discipline of Sport and Exercise Science, University of Canberra Research Institute for Sport and Exercise, Faculty of Health, University of Canberra, Canberra, New South Wales, Australia
| | - Katrina D DuBose
- Department of Kinesiology, East Carolina University, Greenville, North Carolina, USA.,East Carolina Diabetes and Obesity Institute, East Carolina University, Greenville, North Carolina, USA
| | - Unathi Kolanisi
- Department of Consumer Science, University of Zululand, KwaDlangezwa, South Africa
| | - Stuart J Semple
- Discipline of Sport and Exercise Science, University of Canberra Research Institute for Sport and Exercise, Faculty of Health, University of Canberra, Canberra, New South Wales, Australia
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Oliveira RS, Barker AR, Wilkinson KM, Abbott RA, Williams CA. Is cardiac autonomic function associated with cardiorespiratory fitness and physical activity in children and adolescents? A systematic review of cross-sectional studies. Int J Cardiol 2017; 236:113-122. [PMID: 28238507 DOI: 10.1016/j.ijcard.2017.02.022] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Revised: 01/11/2017] [Accepted: 02/03/2017] [Indexed: 01/24/2023]
Abstract
BACKGROUND Heart rate variability (HRV) is considered to explain improvements in cardiovascular health accrued by physical activity (PA) and cardiorespiratory fitness (CRF) over and above traditional cardiovascular risk factors. OBJECTIVE To systematically address associations between HRV, PA and CRF in children and adolescents. DATA SOURCES Medline, EMBASE, SportDISCUS and CINAHL Plus were searched on 5th September 2015 and updated on 4th August 2016. ELIGIBILITY CRITERIA Observational studies comparing HRV in different groups of PA and CRF, and/or studies investigating associations between PA, CRF and HRV. Sports practices and PA intensities were also included. The square root of the mean of the sum of the squares of differences between adjacent RR intervals (RMSSD), the spectral density in the high (HF) and low (LF) frequency, and the LF/HF ratio were included. Risk of bias was assessed using the adapted Newcastle-Ottawa Scale (NOS). RESULTS Heterogeneity exists in the assessment of the exposures and outcomes, and sample characteristics. Risk of bias (NOS) was observed in most of the studies. Studies with low risk of bias showed positive associations between moderate-to-vigorous PA and RMSSD. The evidence for the associations between PA and frequency indices is weak. Similarly, the evidence for the association between CRF and HRV is weak. CONCLUSIONS Despite the heterogeneity in the studies, moderate-to-vigorous PA is positively associated with RMSSD, but less clear are the associations between CRF and HRV, as well as other PA intensities. Further research is needed to clarify the role of PA and CRF on HRV in children and adolescents.
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Affiliation(s)
- Ricardo Santos Oliveira
- Children's Health and Exercise Research Centre, Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, Exeter, UK
| | - Alan Robert Barker
- Children's Health and Exercise Research Centre, Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, Exeter, UK
| | - Kelly Michelle Wilkinson
- Children's Health and Exercise Research Centre, Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, Exeter, UK
| | - Rebecca Anne Abbott
- Evidence Synthesis and Modelling for Health Improvement (ESMI), University of Exeter Medical School, University of Exeter, Exeter, UK
| | - Craig Anthony Williams
- Children's Health and Exercise Research Centre, Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, Exeter, UK.
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Herzig D, Eser P, Radtke T, Wenger A, Rusterholz T, Wilhelm M, Achermann P, Arhab A, Jenni OG, Kakebeeke TH, Leeger-Aschmann CS, Messerli-Bürgy N, Meyer AH, Munsch S, Puder JJ, Schmutz EA, Stülb K, Zysset AE, Kriemler S. Relation of Heart Rate and its Variability during Sleep with Age, Physical Activity, and Body Composition in Young Children. Front Physiol 2017; 8:109. [PMID: 28286485 PMCID: PMC5323426 DOI: 10.3389/fphys.2017.00109] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Accepted: 02/09/2017] [Indexed: 11/13/2022] Open
Abstract
Background: Recent studies have claimed a positive effect of physical activity and body composition on vagal tone. In pediatric populations, there is a pronounced decrease in heart rate with age. While this decrease is often interpreted as an age-related increase in vagal tone, there is some evidence that it may be related to a decrease in intrinsic heart rate. This factor has not been taken into account in most previous studies. The aim of the present study was to assess the association between physical activity and/or body composition and heart rate variability (HRV) independently of the decline in heart rate in young children. Methods: Anthropometric measurements were taken in 309 children aged 2–6 years. Ambulatory electrocardiograms were collected over 14–18 h comprising a full night and accelerometry over 7 days. HRV was determined of three different night segments: (1) over 5 min during deep sleep identified automatically based on HRV characteristics; (2) during a 20 min segment starting 15 min after sleep onset; (3) over a 4-h segment between midnight and 4 a.m. Linear models were computed for HRV parameters with anthropometric and physical activity variables adjusted for heart rate and other confounding variables (e.g., age for physical activity models). Results: We found a decline in heart rate with increasing physical activity and decreasing skinfold thickness. HRV parameters decreased with increasing age, height, and weight in HR-adjusted regression models. These relationships were only found in segments of deep sleep detected automatically based on HRV or manually 15 min after sleep onset, but not in the 4-h segment with random sleep phases. Conclusions: Contrary to most previous studies, we found no increase of standard HRV parameters with age, however, when adjusted for heart rate, there was a significant decrease of HRV parameters with increasing age. Without knowing intrinsic heart rate correct interpretation of HRV in growing children is impossible.
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Affiliation(s)
- David Herzig
- Preventive Cardiology and Sports Medicine, University Clinic for Cardiology, Inselspital, Bern University Hospital, University of Bern Bern, Switzerland
| | - Prisca Eser
- Preventive Cardiology and Sports Medicine, University Clinic for Cardiology, Inselspital, Bern University Hospital, University of Bern Bern, Switzerland
| | - Thomas Radtke
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich Zurich, Switzerland
| | - Alina Wenger
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich Zurich, Switzerland
| | - Thomas Rusterholz
- Institute of Pharmacology and Toxicology, University of ZurichZurich, Switzerland; University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of BernBern, Switzerland
| | - Matthias Wilhelm
- Preventive Cardiology and Sports Medicine, University Clinic for Cardiology, Inselspital, Bern University Hospital, University of Bern Bern, Switzerland
| | - Peter Achermann
- Institute of Pharmacology and Toxicology, University of ZurichZurich, Switzerland; Zurich Center for Integrative Human Physiology, University of ZurichZurich, Switzerland
| | - Amar Arhab
- Endocrinology, Diabetes, and Metabolism Service, Centre Hospitalier Universitaire Vaudois (CHUV) Lausanne, Switzerland
| | - Oskar G Jenni
- Child Development Center, University Children's Hospital ZurichZurich, Switzerland; Children's Research Center, University Children's Hospital ZurichZurich, Switzerland
| | - Tanja H Kakebeeke
- Child Development Center, University Children's Hospital ZurichZurich, Switzerland; Children's Research Center, University Children's Hospital ZurichZurich, Switzerland
| | | | - Nadine Messerli-Bürgy
- Endocrinology, Diabetes, and Metabolism Service, Centre Hospitalier Universitaire Vaudois (CHUV)Lausanne, Switzerland; Department of Clinical Psychology and Psychotherapy, University of FribourgFribourg, Switzerland
| | - Andrea H Meyer
- Department of Psychology, University of Basel Basel, Switzerland
| | - Simone Munsch
- Department of Clinical Psychology and Psychotherapy, University of Fribourg Fribourg, Switzerland
| | - Jardena J Puder
- Endocrinology, Diabetes, and Metabolism Service, Centre Hospitalier Universitaire Vaudois (CHUV)Lausanne, Switzerland; Division of Pediatric Endocrinology, Diabetology and Obesity, Centre Hospitalier Universitaire Vaudois (CHUV)Lausanne, Switzerland
| | - Einat A Schmutz
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich Zurich, Switzerland
| | - Kerstin Stülb
- Department of Clinical Psychology and Psychotherapy, University of Fribourg Fribourg, Switzerland
| | - Annina E Zysset
- Child Development Center, University Children's Hospital Zurich Zurich, Switzerland
| | - Susi Kriemler
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich Zurich, Switzerland
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Correlation between physical activity, aerobic fitness and body fat against autonomic function profile in children. Clin Auton Res 2016; 26:197-203. [PMID: 27052321 DOI: 10.1007/s10286-016-0355-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Accepted: 03/17/2016] [Indexed: 10/22/2022]
Abstract
AIM To evaluate correlations between physical activity, VO2PEAK and body fat versus autonomic function in children. METHODS Children (n = 98) between 10 and 12 years underwent a maximal exercise test (VO2PEAK) and dual-energy X-ray absorptiometry measured body fat. General physical activity, moderate to vigorous physical activity and vigorous physical activity were assessed by accelerometers. Deep breath test with E/I-ratio calculation and a head-up tilt test were performed. The sum of z-scores represented an index score for autonomic function profile and included E/I-ratio plus difference in blood pressure and heart rate between supine and tilted position. Correlation analyses were performed between physical activity parameters, body fat and VO2PEAK versus autonomic function profile. RESULTS No significant correlations were found between autonomic function profile and physical activity or body fat (p > 0.05). VO2PEAK was correlated with autonomic function profile in boys (r = 0.30, p < 0.05), but not in girls (r = 0.04, NS). One girl and eight boys terminated head-up tilt test prematurely due to intolerance. Minutes of vigorous physical activity per day was lower in these boys compared with those (n = 48) who completed the head-up tilt test (5.1 ± 3.3 vs. 10.4 ± 6.6, p < 0.05). CONCLUSION Physical activity or body fat was not associated with autonomic function profile. VO2PEAK correlated to autonomic function profile in boys.
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Fernandes L, Oliveira J, Soares-Miranda L, Rebelo A, Brito J. Regular Football Practice Improves Autonomic Cardiac Function in Male Children. Asian J Sports Med 2015; 6:e24037. [PMID: 26448848 PMCID: PMC4594136 DOI: 10.5812/asjsm.24037] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2013] [Revised: 03/03/2014] [Indexed: 01/08/2023] Open
Abstract
Background: The role of the autonomic nervous system (ANS) in the cardiovascular regulation is of primal importance. Since it has been associated with adverse conditions such as cardiac arrhythmias, sudden death, sleep disorders, hypertension and obesity. Objectives: The present study aimed to investigate the impact of recreational football practice on the autonomic cardiac function of male children, as measured by heart rate variability. Patients and Methods: Forty-seven male children aged 9 - 12 years were selected according to their engagement with football oriented practice outside school context. The children were divided into a football group (FG; n = 22) and a control group (CG; n = 25). The FG had regular football practices, with 2 weekly training sessions and occasional weekend matches. The CG was not engaged with any physical activity other than complementary school-based physical education classes. Data from physical activity, physical fitness, and heart rate variability measured in time and frequency domains were obtained. Results: The anthropometric and body composition characteristics were similar in both groups (P > 0.05). The groups were also similar in time spent daily on moderate-to-vigorous physical activities (FG vs. CG: 114 ± 64 vs. 87 ± 55 minutes; P > 0.05). However, the FG performed better (P < 0.05) in Yo-Yo intermittent endurance test (1394 ± 558 vs. 778 ± 408 m) and 15-m sprint test (3.06 ± 0.17 vs. 3.20 ± 0.23 s). Also, the FG presented enhanced autonomic function. Significant differences were detected (P < 0.05) between groups for low frequency normalized units (38.0 ± 15.2 vs. 47.3 ± 14.2 n.u (normalized units)), high frequency normalized units (62.1 ± 15.2 vs. 52.8 ± 14.2 n.u.), and LF:HF ratio (0.7 ± 0.4 vs. 1.1 ± 0.6 ms2). Conclusions: Children engaged with regular football practice presented enhanced physical fitness and autonomic function, by increasing vagal tone at rest.
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Affiliation(s)
- Luis Fernandes
- Centre of Research, Education, Innovation and Intervention in Sport, Faculty of Sport, University of Porto, Porto, Portugal
- Corresponding author: Luis Fernandes, Centre of Research, Education, Innovation and Intervention in Sport, Faculty of Sport, University of Porto, Porto, Portugal. Tel: +351-220425200, E-mail:
| | - Jose Oliveira
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Portugal
| | - Luisa Soares-Miranda
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Portugal
| | - Antonio Rebelo
- Centre of Research, Education, Innovation and Intervention in Sport, Faculty of Sport, University of Porto, Porto, Portugal
| | - Joao Brito
- Portuguese Football Federation, Health and Performance Unit, Lisbon, Portugal
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Cayres SU, Vanderlei LCM, Rodrigues AM, Silva MJCE, Codogno JS, Barbosa MF, Fernandes RA. [Sports practice is related to parasympathetic activity in adolescents]. REVISTA PAULISTA DE PEDIATRIA 2015; 33:174-80. [PMID: 25887927 PMCID: PMC4516371 DOI: 10.1016/j.rpped.2014.09.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/14/2014] [Accepted: 09/30/2014] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To analyze the relationship among sports practice, physical education class, habitual physical activity and cardiovascular risk in adolescents. METHODS Cross-sectional study with 120 schoolchildren (mean: 11.7±0.7 years old), with no regular use of medicines. Sports practice and physical education classes were assessed through face-to-face interview, while habitual physical activity was assessed by pedometers. Body weight, height and height-cephalic trunk were used to estimate maturation. The following variables were measured: body fatness, blood pressure, resting heart rate, blood flow velocity, intima-media thickness (carotid and femoral) and heart rate variability (mean between consecutive heartbeats and statistical index in the time domain that show the autonomic parasympathetic nervous system activity root-mean by the square of differences between adjacent normal R-R intervals in a time interval. Statistical treatment used Spearman correlation adjusted by sex, ethnicity, age, body fatness and maturation. RESULTS Independently of potential confounders, sports practice was positively related to autonomic parasympathetic nervous system activity (β=0.039 [0.01; 0.76]). On the other hand, the relationship between sport practice and mean between consecutive heartbeats (β=0,031 [-0.01; 0.07]) was significantly mediated by biological maturation. CONCLUSIONS Sport practice was related to higher heart rate variability at rest.
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Radtke T, Eser P, Kriemler S, Saner H, Wilhelm M. Adolescent blood pressure hyperreactors have a higher reactive hyperemic index at the fingertip. Eur J Appl Physiol 2014; 113:2991-3000. [PMID: 24077645 DOI: 10.1007/s00421-013-2735-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2013] [Accepted: 09/20/2013] [Indexed: 01/01/2023]
Abstract
PURPOSE The use of peripheral arterial tonometry (PAT) to assess microvascular endothelial function is getting increasingly popular in the pediatric population. The aim of the present study was to examine the impact of blood pressure (BP) hyperreactivity on microvascular hyperemic reaction in healthy, normotensive adolescents. METHODS Fifty-two adolescents with a mean age of 14.5 ± 0.7 years were investigated. Microvascular endothelial function was assessed at rest and after exhaustive cycling exercise using PAT to determine the reactive hyperemic index (RHI, primary endpoint). Hyperreactors were identified according to their cardiovascular response to a cold pressor test. Indices of autonomic tone were assessed with an ambulatory electrocardiograph and cardiopulmonary exercise testing was performed on a cycle ergometer. Physical activity was measured using accelerometry. ANOVA with repeated measures and Tukey HSD post hoc tests were applied to determine differences between BP hyperreactors and controls (normal reactors). RESULTS Sixteen adolescents were identified as hyperreactors and matched with regard to age, sex, pubertal status, and height with 16 normal reactors. At rest, hyperreactors had a significantly higher RHI than normal reactors (2.1 ± 0.4 vs. 1.6 ± 0.4, P = 0.003). After exhaustive cycling exercise, the differences in RHI were abolished. No differences between these two groups existed in physical activity levels, exercise capacity and indices of autonomic tone. CONCLUSIONS Our data suggest that normotensive hyperreactors have a markedly higher RHI compared to normal reactors. Future studies using PAT to assess microvascular endothelial function should bare in mind the large effect of vascular hyperreactivity.
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