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Autonomic Function Following Concussion in Youth Athletes: An Exploration of Heart Rate Variability Using 24-hour Recording Methodology
Published on: September 21, 2018
Circadian rhythm of heart rate and heart rate variability
M M Massin1, K Maeyns, N Withofs
1Division of Pediatric Cardiology, CHR Citadelle (University of Liège), Boulevard du 12(è) de Ligne, 1, B-4000 Liège, Belgium. martial.massin@chrcitadelle.be
Insights
Children exhibit a daily rhythm in heart rate and heart rate variability (HRV) starting in infancy, linked to sleep maturation and autonomic nervous system development.
Area of Science:
- Pediatric Cardiology
- Autonomic Nervous System Physiology
- Chronobiology
Background:
- Heart rate variability (HRV) is a key indicator of cardiac autonomic function.
- Understanding circadian rhythms in HRV is crucial for pediatric health assessment.
Purpose of the Study:
- To investigate the daily variations in heart rate and HRV in children.
- To explore the relationship between these rhythms and sleep maturation.
Main Methods:
- Ambulatory 24-hour Holter monitoring in 57 healthy children (2 months–15 years).
- Analysis of heart rate and HRV parameters (time and frequency domains) using chronobiological methods.
- Inclusion of teenagers with diabetes and vagal neuropathy for comparative analysis.
Main Results:
- Significant circadian rhythms in heart rate and HRV were observed from late infancy/early childhood.
- Rhythms were characterized by increased variability during sleep, except for the low to high frequency ratio.
- Circadian variations were associated with sleep maturation and normalized in diabetic patients.
Conclusions:
- A distinct circadian rhythm of heart rate and HRV exists in children.
- These findings support the progressive maturation of the autonomic nervous system.
- Sleep organization and associated sympathetic withdrawal are likely drivers of these observed rhythms.
Background:
Measurements of heart rate variability (HRV) are increasingly used as markers of cardiac autonomic activity.
Aim:
To examine circadian variation in heart rate and HRV in children.
Subjects:
A total of 57 healthy infants and children, aged 2 months to 15 years, underwent ambulatory 24 hour Holter recording. Monitoring was also performed on five teenagers with diabetes mellitus and subclinical vagal neuropathy in order to identify the origin of the circadian variation in HRV.
Methods:
The following variables were determined hourly: mean RR interval, four time domain (SDNN, SDNNi, rMSSD, and pNN50) and four frequency domain indices (very low, low and high frequency indices, low to high frequency ratio). A chronobiological analysis was made by cosinor method for each variable.
Results:
A significant circadian variation in heart rate and HRV was present from late infancy or early childhood, characterised by a rise during sleep, except for the low to high frequency ratio that increased during daytime. The appearance of these circadian rhythms was associated with sleep maturation. Time of peak variability did not depend on age. Circadian variation was normal in patients with diabetes mellitus.
Conclusion:
We have identified a circadian rhythm of heart rate and HRV in infants and children. Our data confirm a progressive maturation of the autonomic nervous system and support the hypothesis that the organisation of sleep, associated with sympathetic withdrawal, is responsible for these rhythms.
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