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: