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Measuring Cardiac Autonomic Nervous System (ANS) Activity in Children
Published on: April 29, 2013
Vascular and autonomic function in preschool-aged children with congenital heart disease
Katharine D Currie1, Audra A Martin, Philip J Millar
1Department of Kinesiology Child Health and Exercise Medicine Program, McMaster Children's Hospital, Hamilton, ON, Canada.
Insights
Preschoolers with repaired congenital heart disease (CHD) show early vascular remodeling signs, indicated by higher carotid artery pulse pressures and wall/lumen ratios. However, autonomic and vascular function remain unaffected, warranting further study on long-term cardiovascular risk.
Area of Science:
- Pediatric Cardiology
- Vascular Biology
- Cardiovascular Health
Background:
- Congenital heart disease (CHD) affects numerous children, requiring surgical repair.
- Long-term cardiovascular health outcomes in repaired pediatric CHD are not fully understood.
- Early detection of vascular changes is crucial for managing lifelong cardiovascular risk.
Purpose of the Study:
- To compare vascular health and heart rate variability in preschool-aged children with repaired CHD versus healthy controls.
- To identify potential early markers of vascular remodeling or dysfunction in pediatric CHD survivors.
Main Methods:
- A cross-sectional study involving 12 preschool-aged children with repaired CHD and 12 age/gender-matched healthy controls.
- Noninvasive assessments included heart rate variability, pulse wave velocity, blood pressure, and carotid artery parameters (distensibility, diameter, intima-media thickness, wall/lumen ratio).
Main Results:
- Children with repaired CHD had significantly higher carotid artery pulse pressures and wall/lumen ratios compared to controls.
- No significant differences were observed in resting blood pressure, pulse wave velocity, heart rate variability, or carotid artery distensibility, diameter, and intima-media thickness between groups.
- Children with repaired CHD exhibited lower body mass index values and percentiles.
Conclusions:
- Preschool-aged children with repaired CHD may exhibit early signs of vascular remodeling.
- No evidence of autonomic or vascular dysfunction was found in this cohort.
- The clinical significance of increased carotid artery wall/lumen ratios in repaired CHD requires further investigation.
Objective:
To compare indices of vascular health and heart rate variability in preschool-aged children with repaired congenital heart disease (CHD) including tetralogy of Fallot (n = 6) and coarctation of the aorta (n = 6).
Design:
A cross-sectional study design was used. All measures were noninvasive and collected over a single testing session under the supervision of a parent/guardian.
Setting:
Data collection took place in a quiet, temperature-controlled room (23°± 1°C) with the participant in a supine position.
Patients:
Twelve (six females, six males) preschool-aged children with repaired CHD (CHD: 4 ± 1 years) and 12 age- and gender-matched healthy controls (CON: 5 ± 1 years) participated in the study.
Outcome Measures:
Supine, resting measures of heart rate variability (time, frequency, and nonlinear domains), whole-body pulse wave velocity (ventricular depolarization to dorsalis pedis artery), brachial blood pressures, and carotid artery distensibility, lumen diameter, intima-media thickness, and wall/lumen ratio were collected in both groups.
Results:
The groups were similar in age, height, and weight; however, CON had significantly higher body mass index values (CON: 16.9 ± 2.2, CHD: 15.1 ± 1.0, P < .05) and body mass index percentiles (CON: 69 ± 27%tile, CHD: 36 ± 24%tile, P < .01) compared to CHD. No group differences were found for resting brachial blood pressures, whole-body pulse wave velocity, heart rate variability, and carotid artery distensibility, lumen diameter, and intima-media thickness (P > .05). Carotid artery pulse pressures (CHD: 38 ± 6 mm Hg, CON: 31 ± 6 mm Hg, P < .05) and wall/lumen ratios (CHD: 0.091 ± 0.007, CON: 0.085 ± 0.006, P < .01) were significantly higher in the CHD group.
Conclusions:
These results may indicate that preschool-aged children with repaired CHD display early signs of vascular remodeling, but not autonomic or vascular dysfunction. The effects of larger wall/lumen ratios on cardiovascular disease risk require further investigation.
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