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Heart rate variability in individuals with Down syndrome - A systematic review and meta-analysis
Tatiana Dias de Carvalho1, Thais Massetti2, Talita Dias da Silva3
1Universidade Federal de São Paulo (UNIFESP), Departamento de Medicina, Disciplina de Cardiologia, São Paulo, SP, Brazil; Universidad Nacional de La Matanza (UNLaM), Departamento de Ciencias de la Salud, Kinesiología y Fisiatría, San Justo, BA, Argentina.
Insights
Heart rate variability (HRV) analysis in individuals with Down syndrome (DS) reveals autonomic dysfunction. While resting HRV shows no overall difference, the RMSSD index is significantly lower in DS individuals compared to controls.
Area of Science:
- Cardiology
- Autonomic Neuroscience
- Genetics
Background:
- Down syndrome (DS) is associated with cardiac autonomic modulation dysfunction.
- Heart rate variability (HRV) is a key metric for assessing autonomic function and predicting cardiovascular events.
Purpose of the Study:
- To systematically review and meta-analyze existing research on heart rate variability in individuals with Down syndrome.
- To compare cardiac autonomic modulation between individuals with DS and control groups at rest.
Main Methods:
- A systematic literature search was conducted across PubMed, PubMed Central, and Web of Science.
- Included studies focused on Down syndrome, heart rate variability, autonomic nervous system, autonomic dysfunction, and cardiac autonomic modulation.
- A meta-analysis compared DS individuals to controls at rest using random effects models.
Main Results:
- Of 271 studies, 13 met the inclusion criteria for the review.
- Meta-analysis indicated no significant overall differences in resting heart rate variability between DS and control groups.
- A significant difference was observed in the RMSSD index, which was lower in individuals with DS (Hedge's g = -0.55, p = 0.005).
Conclusions:
- Autonomic dysfunction is present in individuals with Down syndrome, though not always evident during rest.
- The lower RMSSD index in DS individuals suggests altered cardiac autonomic modulation.
- Further investigation into autonomic tasks may better reveal dysfunction in DS.
Introduction:
Down syndrome (DS) results in many changes, including dysfunction in cardiac autonomic modulation. Heart rate variability (HRV) analysis evaluates the autonomic function and it is a predictor of adverse cardiovascular events.
Objective:
To present results of a systematic review and a meta-analysis about heart rate variability in individuals with DS.
Method:
A systematic review was performed on PubMed, PubMed Central and Web of science databases. We included articles that exhibited all the terms: "Down Syndrome", "heart rate variability", "autonomic nervous system", "autonomic dysfunction" and "cardiac autonomic modulation". We conducted the meta-analysis to compare "DS" to "controls" during rest. Random effects models were used, as were appropriate tests for heterogeneity.
Results:
From 271 studies, 13 were included in our review. These are conducted with volunteers from a wide age range, of either gender, and not taking medications. Meta-analysis displayed that there were no significant differences between the groups at rest, except the RMSSD, which revealed a significant (Z = -2.80, p = 0.005) main effect (Hedge's g = -0.55, 95% CI [-0.93; -0.16]), indicating difference in individuals with DS compared with controls.
Conclusion:
There is autonomic dysfunction in individuals with DS, which may or may not be expressed at rest, but it is usually demonstrated in an autonomic task. Meta-analysis specified that there was no significant alteration between DS and the controls during rest, except RMSSD index which was lower in DS than controls.
Prospero:
CRD42017068647.
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