上呼吸道阻塞之兒童開刀前後其HRV均較正常者低

Spectral and Time-Domain Analyses of Heart-Rate Variability in

Children with Severe Upper Airway Obstruction

Berna Şaylan1, Ayhan Çevik2, Vedide Tavlı3, Ayça Vitrinel4

1Department of Pediatric Cardiology, Dışkapı Children’s Hospital, Ankara, Turkey

2Department of Pediatric Cardiology, Faculty of Medicine, Gazi University, Ankara, Turkey

3Department of Pediatric Cardiology, Faculty of Medicine, Yeditepe University, İstanbul, Turkey

4Department of Pediatrics, Faculty of Medicine, Yeditepe University, İstanbul, Turkey

 

www.tutfd.org/pdf.php3?id=745 

 

ABSTRACT

Objective: Heart rate variability (HRV) is a noninvasive index of neural activity of the heart. This study assessed the heart-rate variability response in

children with severe upper airway obstruction.

Material and Methods: A prospective trial was carried out in 15 children with severe adenoid and/or tonsil hypertrophy, compared to 15 age matched

healthy children in order to attempt to relate such changes. Frequency domain measurements of the high and low frequency bands and the ratio low

frequency/high frequency were derived from Holter electrocardiography recordings and computed by Fast Fourier analysis for fi ve minute intervals.

Time domain measurements were derived from 24 hour Holter recordings.

Results: All spectral analysis of heart rate variability was altered in both preoperative and postoperative (three months after the operation) recordings

compared to the control group. In both groups, time domain indices were significantly lower compared to the control group. Mean R-R values were significantly reduced in pre and postoperative groups compared with control group, with the night time mean R-R values being signifi cantly lower (p<0.05).

These results indicate the increased frequency domain parameters in two groups.

Conclusion: In this study, patients demonstrated altered volume loads and autonomic response. Further studies are needed to assess when such cardiac

fi ndings normalize upon relief of the upper airway obstruction.

Key Words: Heart-rate variability, children, airway

Received: 10.09.2009 Accepted: