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Heart rate variability in childhood obesity
1Department of Medicine and Experimental Oncology, S. Vito Hospital, University of Turin, Italy.
Insights
Pediatric obesity is linked to decreased parasympathetic heart rate control, indicated by reduced heart rate variability (HRV) and increased blood pressure. This suggests early cardiac autonomic dysfunction in obese children.
Area of Science:
- Cardiology
- Pediatrics
- Autonomic Nervous System
Background:
- Obesity presents with significant hemodynamic and metabolic changes.
- The role of autonomic control in cardiac function in obese individuals is not fully understood.
- Early detection of cardiac autonomic dysfunction is crucial in pediatric obesity.
Purpose of the Study:
- To investigate early signs of cardiac autonomic dysfunction in obese children.
- To analyze heart rate variability (HRV) using time- and frequency-domain methods.
- To assess autonomic control of cardiac function in a pediatric population with obesity.
Main Methods:
- Comparison of 32 obese children with 13 healthy lean children.
- Utilized 24-hour electrocardiograph and ambulatory blood pressure monitoring.
- Analyzed time- and frequency-domain heart rate variability (HRV) parameters, including low-frequency (LF) and high-frequency (HF) power, and LF/HF ratio.
Main Results:
- Obese children exhibited higher blood pressure, fasting glucose, insulin, and triglyceride levels.
- No significant overall decrease in HRV was observed in the obese group.
- Obese children showed significantly reduced 24-hour and nighttime high-frequency (HF) normalized units and time-domain measures of vagal activity.
- The obese group displayed significantly greater 24-hour and nighttime LF/HF ratios, indicating sympathetic dominance.
Conclusions:
- Obesity in children is associated with increased heart rate and blood pressure.
- A decrease in parasympathetic heart rate control was identified in stabilized obese normotensive children.
- These findings suggest early cardiac autonomic dysfunction in pediatric obesity.
Unlabelled:
Obesity is characterized by hemodynamic and metabolic alterations. Autonomic control on cardiac function involvement is controversial. The aim of the study was to assess early sign of cardiac autonomic dysfunction in obesity, using time- and frequency-domain heart rate variability (HRV) analysis in a pediatric population.
Methods:
32 obese children (OB) (17 M, 15 F; 13.9 +/- 1.7 y) were compared with 13 healthy lean subjects (7 M, 6 F; 12.9 +/- 1.6 y). For each participant, the authors performed a clinical examination, laboratory testing, blood pressure (BP) measurements, and 24-hour electrocardiograph/ambulatory BP monitoring. The spectral power was quantified in total power, low-frequency (LF) power, index of sympathetic tone, high-frequency (HF) power, index of vagal tone, and LF/HF ratio. Low frequency and HF were averaged to obtain 3 measures: 24-hour, daytime, and nighttime levels. Total, long-term, and short-term time-domain HRV values were calculated.
Results:
The obese children had higher casual and ambulatory BP, and higher fasting glucose, insulin, and triglyceride levels. Overall HRV values were not significantly lower in OB. The obese children had significantly lower 24-hour and nighttime high-frequency normalized units, and time-domain measures of vagal activity. Low-frequency power showed an inverse but not significant pattern. The OB group had significantly greater 24-hour and nighttime LF/HF ratios.
Conclusions:
The authors found an increase in heart rate and in BP associated with parasympathetic heart rate control decrease in stabilized obese normotensive children.