Heart Rate Variability Analysis to Evaluate Autonomic Nervous System Maturation in Neonates: An Expert Opinion

Patural, Hugues; Franco, Patricia; Pichot, Vincent; Giraud, Antoine

doi:10.3389/fped.2022.860145

Cited by 7 publications

(6 citation statements)

References 50 publications

(47 reference statements)

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“…In particular, the low values of the HRV are a main indicator of lack of parasympathetic maturation in preterm newborns. 13 Our research demonstrated a beneficial effect on the developmental trajectory of parasympathetic function in preterm infants exposed for two weeks to maternal live singing during hospitalization, with increased values of HF in the intervention group.…”

Section: Discussionmentioning

confidence: 54%

“…12 As preterm infants age, there is a large increase in HRV parameters, especially in the HF, which is interpreted as a main indicator of parasympathetic maturation. 13 In turn, the progressive activation of the parasympathetic tone reflects the gradual maturation of the newborn's ANS. The development of the newborn brain during the earliest stages of the neonatal period ensures that higher cortical processes integrate autonomic control, and this process results in a predominant parasympathetic activity in overall autonomic maturation during the first 2 years of life.…”

Section: Introductionmentioning

confidence: 99%

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Maternal singing sustains preterm hospitalized newborns’ autonomic nervous system maturation: an RCT

Filippa,

Nardelli,

Sansavini

et al. 2023

Pediatr Res

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Background Premature birth is known to affect the newborn’s autonomic nervous system (ANS) maturation, with potential short and long-term impact on their neurobehavioral development. The purpose of the study was to investigate the effects of maternal directed singing and speaking on the preterm infants’ autonomic nervous system (ANS) maturation as measured by the heart rate variability (HRV) parameters. Methods In this multi-center randomized clinical trial, 30 stable preterm infants (m = 29,6 weeks of gestational age), without any abnormalities were randomized into an intervention (16) or a control group (14). HRV was measured weekly, for a total of 80 recordings during hospitalization, as well as before and after each session of singing or speaking. Results The intervention group showed a significant increase of the percentage value of HRV power in the high frequency range when compared to the control group (p = 0.044). More specifically, the maternal singing significantly increased the high frequency power and decreased the low/high frequency power ratio (p = 0.037). Conclusions The preterm infant’s vagal activity significantly increased in the intervention group, potentially enhancing their ANS maturation. The effect is specifically evidenced in the singing condition. Impact Maternal singing affects the autonomic nervous system maturation of preterm hospitalized newborns in the NICU. No previous studies investigated how early vocal parental intervention can affect preterm infants developement, throught their autonomic nervous system maturation. Early Vocal Contact as an early intervention involving parents has a positive impact on preterm infant’s development and it can be easily implemented in the care of preterm infants. Trial registration NCT04759573, retrospectively registered, 17 February 2021.

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Section: Discussionmentioning

confidence: 54%

Section: Introductionmentioning

confidence: 99%

Maternal singing sustains preterm hospitalized newborns’ autonomic nervous system maturation: an RCT

Filippa,

Nardelli,

Sansavini

et al. 2023

Pediatr Res

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“…Assessment of HRV is a powerful and reliable indicator of general health and can be used to predict future health outcomes 26 . The more variable heart rate is the more effectively it can adjust in response to both external and internal changes that could affect cardiac function.…”

Section: Discussionmentioning

confidence: 99%

“…Assessment of HRV is a powerful and reliable indicator of general health and can be used to predict future health outcomes. 26 The more variable heart rate is the more effectively it can adjust in response to both external and internal changes that could affect cardiac function. Autonomic function matures across gestation before term equivalent age and preterm birth delays maturation of HRV as preterm infants have lower HRV than term infants at termequivalent age.…”

Section: Discussionmentioning

confidence: 99%

Autonomic cardiovascular control is altered by intermittent hypoxia in preterm infants

Yee,

Shetty,

Siriwardhana

et al. 2023

Acta Paediatrica

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AimPreterm infants frequently experience short apnoeas and periodic breathing. Animal studies have shown that repetitive hypoxia associated with periodic breathing can alter autonomic control. We aimed to elucidate if apnoea and periodic breathing were associated with changes in autonomic control assessed using heart rate variability, thus exacerbating the consequences of respiratory disturbance.MethodsForty very preterm infants (15 M/25 F) were studied at 34.3 weeks post‐menstrual age with daytime polysomnography. Total power, low frequency (LF, sympathetic+parasympathetic activity) high frequency (HF, parasympathetic activity) and LF/HF (sympathovagal balance) were calculated.ResultsInfants were divided into those with above and below the median total sleep time spent with respiratory events: Active sleep (AS) 13%, Quiet sleep (QS) 10%. In AS, including respiratory events, Total power (p < 0.05) and HF power (p < 0.05) were higher in the above median group. During AS excluding respiratory events, Total power (p < 0.05) and HF power (p = 0.061) were higher and LF power (p < 0.01) and LF/HF (p < 0.05) were lower in the above median group. There were no differences in HRV parameters in QS.ConclusionThis study provides new evidence that short apnoeas, particularly periodic breathing, which is currently not detected or treated in the neonatal unit can affect autonomic cardiovascular control.

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“…Currently, the mechanism of cardiac dysfunction is thought to involve abnormalities in autonomic nervous system (ANS) function (Teng et al, 2021). Heart rate variability (HRV), as an objective index to evaluate cardiac ANS regulation, is convenient and noninvasive (Patural et al, 2022;Rajendra Acharya et al, 2006). Several studies have suggested that HRV may be a sensitive indicator for evaluating chemotherapy-induced cardiotoxicity.…”

Section: Introductionmentioning

confidence: 99%

Early detection of the impact of combined taxane and carboplatin treatment on autonomic nerves in patients with cervical cancer: Measurement of heart rate variability

Liu

Guan²,

Sun³

et al. 2023

Front. Physiol.

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Background: Previous studies have shown that heart rate variability (HRV) analysis is a sensitive indicator of chemotherapy-induced cardiotoxicity. However, most studies to date have observed long-term effects using long-term analyses. The main purpose of this study was to evaluate the acute effect of chemotherapy on the cardiac autonomic nervous system (ANS) in patients with cervical cancer (CC) by examining short-term HRV.Methods: Fifty patients with CC admitted to the Department of Gynecology and Oncology of the First Affiliated Hospital of Bengbu Medical College were enrolled in the study. Based on their chemotherapy regimens, the patients were divided into a DC group (docetaxel + carboplatin) and a TC group (paclitaxel + carboplatin). A 5-min resting electrocardiogram (ECG) was collected before and the day after chemotherapy: the time domain (standard deviation of normal-to-normal intervals (SDNN) and root mean square of successive differences (RMSSD)) and frequency domain (low-frequency power (LF), high-frequency power (HF), and (LF/HF)) parameters were analyzed, and the differences before and after chemotherapy were compared.Results: The results showed that SDNN, RMSSD and HF were significantly higher in the DC and TC groups after chemotherapy than before (p < 0.05, Cohen’s d > 0.5). In addition, LF was significantly higher after TC than before chemotherapy (p < 0.05, Cohen’s d > 0.3), and LF/HF was significantly lower after DC than before chemotherapy (p < 0.05, Cohen’s d > 0.5).Conclusion: Chemotherapy combining taxane and carboplatin can increase the HRV of CC patients in the short term, and HRV may be a sensitive tool for the early detection of chemotherapy-induced cardiac ANS perturbations.

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Heart Rate Variability Analysis to Evaluate Autonomic Nervous System Maturation in Neonates: An Expert Opinion

Cited by 7 publications

References 50 publications

Maternal singing sustains preterm hospitalized newborns’ autonomic nervous system maturation: an RCT

Maternal singing sustains preterm hospitalized newborns’ autonomic nervous system maturation: an RCT

Autonomic cardiovascular control is altered by intermittent hypoxia in preterm infants

Early detection of the impact of combined taxane and carboplatin treatment on autonomic nerves in patients with cervical cancer: Measurement of heart rate variability

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