The aim of study is to investigate effectiveness of cross-recurrence analysis for the detection of coupling between the loops of heart rate and vessel tone sympathetic control. The cross-recurrence analysis is applied to the interbeat intervals and photopletysmographic signals from the mathematical model of cardiovascular system and from adults and newborn children. The model is examined under the conditions of the four experiments: with fully operational autonomic control, autonomic control weakened by 40%, autonomic control weakened by 70% and autonomic blockade. The coupling is most pronounced in adult subjects and the model with fully operational autonomic control, while it is absent under the autonomic blockade. Autonomic control is also not fully developed in newborn children. As the result, smaller coupling strength is expected. The results of cross-recurrence analysis of the model and experimental data are compared with the results of coupling detection based on the analysos of phase synchronization. Synchronization index demonstrates good correlation with the coupling strength in the model and weak coupling in newborn children in relation to adult subjects. In both cases, no correlation is observed between the synchronization index and the results of cross-recurrence analysis.
Резюме Цель исследования. Оценка эффективности и безопасности применения новой жидкой лекарственной формы препарата Тенотен детский в лечении последствий перинатального поражения ЦНС (ПП ЦНС). Материал и методы. В многоцентровое двойное слепое плацебо-контролируемое рандомизированное исследование были включены 184 ребенка (в возрасте от 29 сут до 9 мес) с последствиями ПП ЦНС, с суммарным значением по шкале психомоторного развития Журбы-Мастюковой 12-27 баллов, показателями физического развития 25-75 центилей. Пациенты были рандомизированы в две группы: дети основной группы получали Тенотен детский (10 капель/сут), пациенты группы сравнения-плацебо. Длительность исследования составила 12 нед ± 5 сут. Доля пациентов с увеличением суммарного балла по шкале Журбы-Мастюковой 4 балла и более была выбрана в качестве первичного критерия эффективности. Результаты и заключение. По первичному критерию эффективности доля пациентов, получавших Тенотен детский, с положительным ответом на терапию составила 77,5% (р=0,02; сравнение с плацебо). Установлено, что препарат Тенотен детский в жидкой форме безопасен при лечении пациентов 1-го года жизни. Применение жидкой лекарственной формы препарата в терапии последствий ПП ЦНС легкой и средней тяжести перспективно с целью достижения терапевтических результатов с минимальным количеством побочных явлений, хорошей переносимостью и высоким уровнем восприятия назначенной терапии.
Heart rate variability values are potentially important for assessing vegetative dysfunction in children.The purpose of the research: a comparative study of spectral heart rate variability parameters and synchronization of low-frequency oscillations, characterizing baroreflex in the vegetative regulation of the cardiovascular system in healthy newborns and adults.15 healthy newborns and 60 healthy individuals in the age of 18-34 years old were included in the study. We performed synchronous recording of electrocardiograms and photoplethysmograms with 10 minutes duration, at rest. Were evaluated spectral heart rate variability indices and the index of synchronization of low-frequency oscillations in heart rate variability and photoplethysmograms (S index).Results. In newborns, the peak of low-frequency oscillations was predominantly in the range 0.07–0.09 Hz, and high frequency 0.40–0.50 Hz. Newborns had lower LF% values than adults: 22.8 (14.1, 29.4) vs 32.9 (25.1, 41.9) (p=0.009). The S index in newborns was 20.1 (16.9, 26.5)%, and 33.2 (21.2, 45.4)% in healthy adults (p=0.023).Conclusion. We have first demonstrated that the interaction of baroreflex regulation of heart rhythm and peripheral blood filling in healthy newborns is characterized by lower values of S index, than in healthy adults, which can be explained by the immaturity of the vegetative regulatory elements of the cardiovascular system.
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