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Heart rate variability in children with aortic valve stenosis - a pilot study

Bozena Werner1, Anna Piorecka-Makula, Waldemar Bobkowski

  • 1Medical University of Warsaw, Poland.

Archives of Medical Science : AMS
|July 13, 2013
PubMed

Insights

Children with aortic valve stenosis (AS) show disturbed autonomic nervous system balance, with lower heart rate variability (HRV) compared to healthy controls. Reduced daytime HRV may signal a risk for ventricular arrhythmia in pediatric AS patients.

Area of Science:

  • Pediatric Cardiology
  • Autonomic Nervous System Function
  • Cardiac Electrophysiology

Background:

  • Aortic valve stenosis (AS) is a significant congenital heart defect in children.
  • Understanding the impact of AS on autonomic nervous system (ANS) function is crucial for risk stratification.
  • Heart rate variability (HRV) serves as a non-invasive marker of ANS activity.

Purpose of the Study:

  • To prospectively evaluate heart rate variability (HRV) in children diagnosed with aortic valve stenosis (AS).
  • To investigate the relationship between HRV parameters and clinical indicators such as left ventricular mass and peak transaortic valve pressure gradient (PG).
  • To assess potential correlations between HRV and the presence of ventricular arrhythmias in pediatric AS patients.

Main Methods:

  • A prospective study involving 60 children with AS, categorized into three groups based on their pressure gradient (PG).
  • Sixty healthy children served as controls.
  • Standard 24-hour Holter ECG monitoring was employed for time-domain HRV analysis.
  • Left ventricular mass was quantified using echocardiography.

Main Results:

  • Children with AS exhibited significantly lower mean values across all assessed HRV parameters compared to healthy controls (p < 0.001).
  • No significant differences in HRV parameters were observed between AS children with varying PGs or with/without myocardial hypertrophy.
  • A statistically significant reduction in daytime HRV (SDNN day) was noted in AS children with ventricular arrhythmia compared to those without (p < 0.05).

Conclusions:

  • The autonomic nervous system balance is disturbed in children with AS, indicating increased sympathetic and decreased parasympathetic activity.
  • Transaortic valve pressure gradient and myocardial hypertrophy do not appear to influence HRV in this cohort.
  • A reduction in daytime HRV (SDNN) may serve as a potential indicator for the risk of ventricular arrhythmias in pediatric patients with AS.
Abstract

Keywords:
aortic stenosischildrenheart rate variability

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