Heart-rate variability in low-risk prematurely born infants reaching normal term: A comparison with full-term newborns

Eiselt, M.; Curzi‐Dascalova, Lilia; Clairambault, Jean; Kauffmann, F.; Médigue, Claire; Peirano, Patricio

doi:10.1016/0378-3782(93)90011-i

Cited by 72 publications

(56 citation statements)

References 21 publications

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“…More recent studies, which followed infants born at 28 weeks PMA and studied longitudinally at weekly intervals until term equivalent age, have also shown that heart rate is elevated in preterm infants compared to term born infants (Patural et al, 2008). In support of these findings, studies comparing preterm and term infants at term have also shown that preterm infants had elevated heart rate in both sleep states compared with term infants (Eiselt et al, 1993). In contrast, other studies have demonstrated no heart rate differences between term and preterm infants (born at 26-32 wks GA) when compared at 2-3 weeks and 2-3 months CA (Tuladhar et al, 2005b) or when followed up to 6 months CA in infants born 28-32 wks GA (Witcombe et al, 2008).…”

Section: Heart Rate and Blood Pressure After Preterm Birthsupporting

confidence: 65%

Cardiovascular Consequences of Preterm Birth in the First Year of Life

Fyfe¹,

Yiallourou²,

Horne³

2012

Preterm Birth - Mother and Child

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Section: Heart Rate and Blood Pressure After Preterm Birthsupporting

confidence: 65%

Cardiovascular Consequences of Preterm Birth in the First Year of Life

Fyfe¹,

Yiallourou²,

Horne³

2012

Preterm Birth - Mother and Child

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“…Although baroreflex sensitivity has been shown to increase with postnatal age in premature infants, it is still depressed when they reach the theoretical term (33). This notion may be related to a change in the balance between the sympathetic and parasympathetic nervous systems, with a diminished parasympathetic component of heart rate control in premature infants (34). Importantly, DC was independent on heart rate in the present study according to previous studies that have shown that increasing heart rate is not associated with any change in aortic stiffness, whereas it affects the timing of the reflected pressure wave, produced by changes in the absolute duration of systole (35-37).…”

Section: Discussionmentioning

confidence: 99%

Characteristics of Arterial Stiffness in Very Low Birth Weight Premature Infants

et al. 2006

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Premature birth is a factor of increased blood pressure in adulthood. Little is known about the physiologic characteristics of the arterial bed in neonates. The aim of this study was to characterize in vivo the arterial compliance in neonates and its maturation profile in very low birth weight (VLBW) premature infants. A group of stable, VLBW premature infants was compared with a control group of near term neonates. The abdominal aortic wall distensibility coefficient (DC) and whole-body arterial compliance (WBAC) were determined using specifically designed noninvasive methods, based on ultrasonic measurements in combination with synchronous, beatto-beat recording of aortic pulse pressure (PP). On the fifth day of life, WBAC and the CD were lower in VLBW premature infants than in controls. Furthermore, WBAC and the DC remained unchanged in VLBW premature infants 7 wk after birth. In conclusion, VLBW premature infants are characterized as early as the fifth day of life by high arterial stiffness, which persists when they reach their theoretical term. It can be speculated that early alteration of arterial elastic properties may pave the way for long-term elevation of arterial pressure in VLBW premature infants. (1) identified a relationship between low birth weight and increased risk of arterial hypertension, carotid arteriosclerosis, and mortality by coronary heart disease or stroke in adulthood. More recently, a relationship has been shown between preterm birth and cardiovascular or metabolic disorders in adult life (2,3). An inverse relationship between adult blood pressure and gestational age has been found in both adult men and women who were born prematurely (4,5). Furthermore, a large epidemiologic study has reported that young male adults born extremely preterm faced an almost twofold increased risk (Ն140 mm Hg) compared with subjects born at term (6). Last, blood pressure, pulse pressure, and vascular resistance have been reported to be increased in preterm girls after puberty (7).Numerous animal studies based on diet restriction during pregnancy, uterine artery ligature, or antenatal exposure to dexamethasone have shown that low birth weight is associated with increased arterial blood pressure in adulthood (8,9). The mechanisms, however, are not fully known. Low birth weight has been shown to be associated with nephron number reduction and increased blood pressure in adulthood (9,10). Moreover, arterial wall structure or properties may be affected, as shown by the relationship between brachial artery flowmediated dilation, endothelium-dependent response, and birth weight (11). Also, an inverse relationship has been observed between pulse wave reflections and birth weight (12). Several authors argue that in fetuses with impaired growth, elastin synthesis in the wall of the aorta and of large arteries may be deficient and may lead to permanent changes in mechanical properties (13,14). Studies aimed at clarifying the relationship between arterial stiffness and low birth weight have led to similar ...

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“…In general, before any drug injection, the parasympathetic activity (reflected by the HF component and rmssd values) is not identical in all children [7,8,12]. During controlled ventilation, the frequency of ventilation could introduce bias.…”

Section: Discussionmentioning

confidence: 99%

Effect of remifentanil with and without atropine on heart rate variability and RR interval in children

et al. 2005

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SummaryRemifentanil can cause bradycardia either by parasympathetic activation or by other negative chronotropic effects. The high frequency (HF) component of heart rate variability (HRV) is a marker of parasympathetic activity. This study aimed to evaluate the effect of remifentanil on RR interval and on HRV in children. Forty children ASA I or II were studied after approval by the human studies committee and informed parental consent was obtained. After stabilisation at sevoflurane 1 MAC, they were randomly divided into two groups: one received a 20 lg.kg atropine injection (AT + REMI) and the other ringer lactate solution (REMI). Three minutes later, a 1 lg.kg )1 bolus of remifentanil was administered over 1 min, followed by a continual infusion at 0.25 lg.kg )1 .min )1 for 10 min increased to 0.5 lg.kg )1 .min )1 for a further 10 min.A time varying, autoregressive analysis of RR sequences was used to estimate classical spectral parameters: low (0.04-0.15 Hz; LF) and high (0.15-0.45 Hz; HF) frequency, whereas the root mean square of successive differences of RR intervals (rmssd) was derived directly from the temporal sequence. Statistical analyses were conducted by means of the multiple correspondence analysis and with non parametrical tests. Remifentanil induced an RR interval lengthening, i.e. bradycardia, in both groups compared to pretreatment values and was associated with an increase of HF and rmssd only for the REMI group. The parasympathetic inhibition by atropine did not totally prevent remifentanil's negative chronotropic effect. A direct negative chronotropic effect of remifentanil is proposed.

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Heart-rate variability in low-risk prematurely born infants reaching normal term: A comparison with full-term newborns

Cited by 72 publications

References 21 publications

Cardiovascular Consequences of Preterm Birth in the First Year of Life

Cardiovascular Consequences of Preterm Birth in the First Year of Life

Characteristics of Arterial Stiffness in Very Low Birth Weight Premature Infants

Effect of remifentanil with and without atropine on heart rate variability and RR interval in children

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