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Developmental patterns of heart rate and variability in infants with persistent apnea of infancy
V L Schechtman1, J A Henslee, R M Harper
1Brain Research Institute, UCLA School of Medicine 90095-1761, USA. vicki@aunix.loni.ucla.edu
Insights
Infants with persistent apnea, whether premature or full-term, exhibit distinct heart rate patterns. These cardiovascular changes suggest that apnea itself, not just premature birth, impacts autonomic control development.
Area of Science:
- Pediatric cardiology
- Neonatology
- Developmental neuroscience
Background:
- Premature infants with persistent apnea show altered heart rate and variability compared to full-term controls.
- Previous research suggests potential links between cardiovascular changes and apnea in premature infants.
Purpose of the Study:
- To investigate if persistent apnea, independent of premature birth, causes cardiovascular differences.
- To compare heart rate and variability in full-term infants with apnea, premature infants with apnea, and full-term controls.
Main Methods:
- Assessed resting heart rate and heart rate variability.
- Compared full-term infants with apnea of infancy, prematurely born infants with persistent apnea, and full-term control infants.
Main Results:
- Full-term infants with persistent apnea displayed slower heart rates from 4 months and enhanced heart rate variability from 6 months post-birth.
- Premature infants with persistent apnea showed similar cardiovascular alterations to full-term infants with apnea.
- These findings differed from alterations seen in very premature infants with a history of respiratory distress syndrome.
Conclusions:
- Cardiovascular aberrations in infants with persistent apnea suggest that apnea-related mechanisms contribute to long-term autonomic control alterations.
- The postnatal development of these aberrations highlights the impact of apneic events on autonomic nervous system regulation.
Abstract:
During periods of regular breathing, heart rate is slower and more variable in healthy (no history of respiratory distress syndrome) prematurely born infants with persistent apnea, relative to full-term control infants of comparable post-conceptional ages. We tested the hypothesis that the cardiovascular differences may be linked to the persistent apnea, rather than premature birth, by assessing heart rate and variability in full-term infants with persistent apnea. Thus, resting heart rate and variability were compared in full-term infants with apnea of infancy, prematurely born infants with persistent apnea, and full-term control infants. Full-term infants with persisting apnea showed slower heart rates than control infants, beginning at 4 months after birth, and enhanced heart rate variability beginning at 6 months. Healthy prematurely born infants with persistent apnea showed cardiovascular alterations similar to those of full-term infants with apnea; these alterations differed from those observed in very premature infants with histories of respiratory distress. The postnatal development of cardiovascular aberrations in infants with persistent apnea suggests that mechanisms accompanying apneic events may contribute to long-term alterations in autonomic control.