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Heart rate variability as a predictor of disease exacerbation in pediatric inflammatory bowel disease
Anat Yerushalmy-Feler1, Shlomi Cohen1, Ronit Lubetzky2
1Pediatric Gastroenterology Unit, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Insights
Heart rate variability (HRV) is lower in pediatric inflammatory bowel disease (IBD) patients. Higher HRV predicts a reduced risk of IBD exacerbation, offering a potential biomarker for disease management.
Area of Science:
- Cardiology
- Gastroenterology
- Pediatrics
Background:
- Heart rate variability (HRV) reflects autonomic nervous system function, particularly parasympathetic vagal activity.
- Previous research indicates lower HRV in adults with inflammatory bowel disease (IBD).
Purpose of the Study:
- To investigate the predictive value of HRV for clinical outcomes in pediatric patients diagnosed with IBD.
- To assess the relationship between HRV metrics and disease activity in children with IBD.
Main Methods:
- A prospective study involving 34 children (12-18 years) with IBD.
- Two 10-minute HRV measurements using a photoplethysmograph finger sensor.
- Calculation of the square root of the mean squared differences of successive R-R pulse intervals (RMSSD) as an index of vagal activity.
Main Results:
- Children in clinical remission exhibited significantly higher RMSSD compared to those with active disease (67.72 ± 27.81 vs. 45.76 ± 22.04, P = 0.022).
- Multivariate analysis identified higher RMSSD as an independent predictor of a lower risk of IBD exacerbation (OR = 0.941, P = 0.044).
Conclusions:
- HRV measurements correlate with IBD activity in pediatric patients.
- HRV, specifically RMSSD, shows potential as an independent prognostic marker for disease exacerbation in pediatric IBD.
Objectives:
Heart rate variability (HRV), a marker of the parasympathetic vagal activity, was reportedly significantly lower in patients with inflammatory bowel disease (IBD) compared to healthy controls. The aim of this study was to evaluate HRV as a predictor of clinical outcomes in pediatric IBD.
Methods:
This was a prospective study. Children (12-18 years of age) with IBD were prospectively recruited. Each patient underwent two 10-min HRV measurements by means of a photoplethysmograph finger sensor. The square root of the mean squared differences of successive R-R pulse intervals (RMSSD), an indirect index of vagal activity, was calculated. Clinical data, including demographic variables, disease activity and course, medications, and laboratory results were collected during a follow-up of 12 months. The relation between RMSSD and clinical outcomes was examined, adjusting for confounders.
Results:
A total of 34 children with IBD were included. Patients in clinical remission had a significantly higher RMSSD compared to patients with active disease (67.72 ± 27.81 versus 45.76 ± 22.04, respectively, P = 0.022). A multivariate analysis revealed that a higher RMSSD was a significant and independent predictor of lower risk of IBD exacerbation (odds ratio = 0.941, 95% confidence interval 0.887-0.998, p = 0.044).
Conclusion:
HRV correlates with IBD activity and may also serve as an independent predictor of disease exacerbation in pediatric IBD.
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