Heart rate variability in individuals with Down syndrome – A systematic review and meta-analysis

Carvalho, Tatiana Dias de; Massetti, Thaís; Silva, Talita Dias da; Crocetta, Tânia Brusque; Guarnieri, Regiani; Vanderlei, Luiz Carlos Marques; Monteiro, Carlos Bandeira de Mello; Garner, David M.; Ferreira, Celso

doi:10.1016/j.autneu.2018.05.006

Cited by 18 publications

(17 citation statements)

References 33 publications

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“…However, they did not have a control group to compare their results. Another study, a systematic review and meta-analysis concluded that individuals with DS, when compared with their controls without DS, did not have significant HR variability at rest [23]. However, the literature remains unclear about the cardiovascular behavior of individuals with the syndrome in stressful situations, such as a dental appointment [4].…”

Section: Discussionmentioning

confidence: 99%

Physiological and Behavioral Manifestations of Children and Teenagers with Down Syndrome During the Dental Appointment: A Comparative Cross-Sectional Study

Silva

Nogueira

Leal

et al. 2020

Pesqui. Bras. Odontopediatria Clín. Integr.

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To measure the heart rate (HR) and the behavior of children and teenagers with Down Syndrome (DS) during the dental appointment. Material and Methods: Two groups (n = 52), of both genders, aged 2-14 years, matched by age group were formed: study group (SG)-individuals with DS and control group (CG)-normotypical school children. The participants were submitted to clinical examination and prophylaxis. An oximeter was used to measure the HR at five moments of the dental consultation: before entering the practice room (T0), when sitting in the dental chair (T1), during the clinical examination (T2), during prophylaxis (T3) and immediately after prophylaxis (T4). Behavior, classified according to the Frankl Scale, was observed at T3. Mann Whitney, Kruskal-Wallis, Dunn and Pearson's Chi-square tests were used to analyze and compare variables (significance level at 5%). Results: In SG, a significant difference in HR was observed according to the moment of dental appointment (p<0.001 SG; 0.3385 CG). The highest HR value in SG was observed at T3 (median 110.00; IIQ 96.00-124.00), the only moment significantly different (p<0.001) from HR values for CG. A difference in behavior between groups (p<0.001) was also observed. Conclusion: HR of individuals with DS varied throughout the dental appointment, and they also had a higher prevalence of uncooperative behavior.

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Section: Discussionmentioning

confidence: 99%

Physiological and Behavioral Manifestations of Children and Teenagers with Down Syndrome During the Dental Appointment: A Comparative Cross-Sectional Study

Silva

Nogueira

Leal

et al. 2020

Pesqui. Bras. Odontopediatria Clín. Integr.

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“…Autonomic dysregulation is a known contributor to lower BP in Ds, particularly during times of increased demand (Fernhall and Otterstetter ; Iellamo et al ; Bunsawat and Baynard ; Hilgenkamp and Baynard ). However, resting sympathetic and parasympathetic control is not standardized across studies although some reports suggest higher parasympathetic tone in controls versus Ds (Goulopoulou et al ; Giagkoudaki et al ; Carvalho et al ). Our proof of concept data suggest that autonomic function measured via HR high frequency power spectra is different between WT and Ts65Dn under 1% isoflurane anesthesia.…”

Section: Discussionmentioning

confidence: 99%

“…We agree that future studies of HRV could include other physiological states in awake mice, but the differences in HR would need to be accounted for in the analyses (Sacha and Pluta ). While multiple comparisons have been reported using HRV in people with Ds (Baynard et al ; Goulopoulou et al ; Giagkoudaki et al ; Bunsawat and Baynard ; Carvalho et al ), there is not a widespread acceptance of baseline autonomic dysfunction in this population. Therefore, it is not possible to directly compare the mouse data to the clinical literature.…”

Section: Discussionmentioning

confidence: 99%

“…Some research questions about Ds would be more appropriately studied in an animal model. For instance, autonomic differences are reported in Ds, but firm conclusions about the sympathetic and parasympathetic contributions at rest are elusive since the clinical literature is conflicting (Baynard et al ; Goulopoulou et al ; Giagkoudaki et al ; Bunsawat and Baynard ; Carvalho et al ). The discrepancies may lie in the various control groups used (age matched, heart rate matched, people with intellectual disability without Ds, etc.)…”

Section: Introductionmentioning

confidence: 99%

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Heart rate and blood pressure in male Ts65Dn mice: a model to investigate cardiovascular responses in Down syndrome

et al. 2019

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Down syndrome (Ds) is the most common chromosomal cause of intellectual disability that results from triplication of chromosome 21 genes. Lower blood pressure (BP) and heart rate (HR) in response to exercise and other stressors are prevalent in Ds, and are mediated by autonomic dysfunction. The Ts65Dn mouse is a model of Ds that is commonly used in preclinical studies, but has not been formally investigated for cardiovascular responses in conscious mice. Based on human studies of Ds, we hypothesized Ts65Dn would have lower BP and HR, but similar arterial stiffness. BP was quantified in conscious wild‐type (WT) and Ts65Dn. A main effect for strain was observed for all BP measures (systolic, diastolic, mean, pulse pressure), with WT higher than Ts65Dn. Pulse wave velocity was similar between WT and Ts65Dn. High‐frequency power spectra was higher in WT suggesting autonomic differences between strains. Freely moving HR was higher in WT versus Ts65Dn in both the dark and light cycles, although a main effect of circadian cycle was also present (dark> light). Similar to what is observed in humans, Ts65Dn has a lower BP which may be attributed to autonomic differences and result in preservation of arterial function with advancing age. Ts65Dn thus appears to capture the Ds cardiovascular phenotype across the lifespan. These data support further use of Ts65Dn to investigate mechanisms that may lead to altered BP and HR responses in Ds.

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“…RSA-BF is of particular relevance given that reduced cardiac vagal control (measured as low HRV or RSA) has been linked to several medical ( Patron et al, 2012 ; Zhou et al, 2016 ; Benichou et al, 2018 ; Carvalho et al, 2018 ) and psychopathological conditions ( Clamor et al, 2016 ; Cheng et al, 2019 ; Koch et al, 2019 ). Indeed, RSA-BF has been shown to effectively improve cardiac vagal control and, in turn, lower anxious and depressive symptoms ( Karavidas et al, 2007 ; Gevirtz, 2013 ; Patron et al, 2013 ; Goessl et al, 2017 ; Caldwell and Steffen, 2018 ) and improve athletic performance, sleep, and quality of life ( Zaccaro et al, 2018 ; Lehrer et al, 2020 ).…”

Section: Introductionmentioning

confidence: 99%

Not All Competitions Come to Harm! Competitive Biofeedback to Increase Respiratory Sinus Arrhythmia in Managers

et al. 2020

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Despite the positive impact on achievement, competition has been associated with elevated psychophysiological activation, potentially leading to a greater risk of cardiovascular diseases. Competitive biofeedback (BF) can be used to highlight the effects of competition on the same physiological responses that are going to be controlled through BF. However, it is still unknown whether competition could enhance the effects of respiratory sinus arrhythmia (RSA)-BF training in improving cardiac vagal control. The present study explored whether competitive RSA-BF could be more effective than non-competitive RSA-BF in increasing RSA in executive managers, who are at higher cardiovascular risk of being commonly exposed to highly competitive conditions. Thirty managers leading outstanding private or public companies were randomly assigned to either a Competition ( n = 14) or a Control ( n = 16) RSA-BF training lasting five weekly sessions. Managers in the Competition group underwent the RSA-BF in couples and each participant was requested to produce a better performance (i.e., higher RSA) than the paired challenger. After the training, results showed that managers in the Competition group succeeded in increasing cardiac vagal control, as supported by the specific increase in RSA ( p < 0.001), the standard deviation of R-R wave intervals (SDNN; p < 0.001), and root mean square of the successive differences between adjacent heartbeats (rMSSD; p < 0.001). A significant increase in the percentage of successive normal sinus beat to beat intervals more than 50 ms (pNN50; p = 0.023; η 2 p = 0.17), low frequency ( p = ≤ 0.001; η 2 p = 0.44), and high frequency power ( p = 0.005; η 2 p = 0.25) emerged independently from the competitive condition. Intriguingly, managers who compete showed the same reduction in resting heart rate (HR; p = 0.003, η 2 p = 0.28), systolic blood pressure (SBP; p = 0.013, η 2 p = 0.20), respiration rate (p < 0.001; η 2 p = 0.46), and skin conductance level (SCL; p = 0.001, η 2 p = 0.32) as non-competitive participants. Also, the same reduction in social anxiety ( p = 0.005; η 2 p = 0.25), state ( p = 0.038, η 2 p = 0.14) and trait anxiety ( p = 0.001, η 2 p = 0.31), and depressive symptoms ( p = 0.023, η ...

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Heart rate variability in individuals with Down syndrome – A systematic review and meta-analysis

Abstract: CRD42017068647.

Cited by 18 publications

References 33 publications

Physiological and Behavioral Manifestations of Children and Teenagers with Down Syndrome During the Dental Appointment: A Comparative Cross-Sectional Study

Physiological and Behavioral Manifestations of Children and Teenagers with Down Syndrome During the Dental Appointment: A Comparative Cross-Sectional Study

Heart rate and blood pressure in male Ts65Dn mice: a model to investigate cardiovascular responses in Down syndrome

Not All Competitions Come to Harm! Competitive Biofeedback to Increase Respiratory Sinus Arrhythmia in Managers

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