Instantaneous heart rate patterns in newborn infants

Urbach, John R.; B, Phuvichit; Zweizig, Helen; Millican, Edith; Carrington, Elsie R.; Loveland, Mary; Williams, Jimmie M.; Lambert, Robert L.; Duncan, Adah M.; Farrell, Shari L.; Simons, Patricia O.; Spurgeon, Irene L.

doi:10.1016/0002-9378(65)90157-2

Cited by 29 publications

(13 citation statements)

References 22 publications

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“…The loss of HRV is reported to reflect an alteration in autonomic nervous system function (16)(17)(18). A number of disease states are associated with changes in HRV, including heart failure (19,20), sudden infant death syndrome (21), myocardial infarction (22,23), prematurity (24), neonatal respiratory distress syndrome (25)(26)(27)(28), and diabetes (29). We hypothesize that CCHS patients will exhibit changes in HRV and that these changes have the potential to provide insights into the nature of autonomic control in CCHS.…”

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confidence: 99%

Heart Rate Variability in Congenital Central Hypoventilation Syndrome

Woo²,

et al. 1992

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ABSTRACT. Heart rate variability was assessed in 12 patients with congenital central hypoventilation syndrome (CCHS) and in age-and sex-matched controls using SD of time intervals between R waves (R-R intervals), R-R interval histograms, spectral analysis, and PoincarC plots of sequential R-R intervals over a 24-h period using ambulatory monitoring. Mean heart rates in patients with CCHS were 103.3 f 17.7 SD and in controls were 98.8 f 21.6 SD ( p > 0.5, NS). SD analysis of R-R intervals showed similar results in both groups (CCHS 102.2 f 36.0 ms versus controls 126.1 f 43.3 ms; p > 0.1, NS). Spectral analysis revealed that, for similar epochs sampled during quiet sleep and wakefulness, the ratios of low-frequency band to high-frequency band spectral power were increased for 11 of 12 patients with CCHS during sleep, whereas a decrease in these ratios was consistently observed in all controls during comparable sleep states (xZ = 20.31; p < 0.000007). During wakefulness, the ratios of low-frequency band to high-frequency band spectral power were similar in both patients with CCHS and controls. Poincare plots displayed significantly reduced beat-to-beat changes at slower heart rates in the CCHS patients (xZ = 24.0; p < 0.000001). The scatter of points in CCHS Poincare plots was easily distinguished from controls. All CCHS patients showed disturbed variability with one or more measures. The changes in moment-to-moment heart rate variability suggest that, in addition to a loss of ventilatory control, CCHS patients exhibit a dysfunction in autonomic nervous system control of the heart. (Pediafr Res 31: 291-296, 1992) Abbreviations CCHS, congenital central hypoventilation syndrome HRV, heart rate variability R-R, time interval between R waves LO-HI, ratio of low-frequency band to high-frequency band spectral power

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Heart Rate Variability in Congenital Central Hypoventilation Syndrome

Woo²,

et al. 1992

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“…This relation implies that delta RR measurements should be corrected for heart rate because delta RR depends not only on the activity and integrity of the autonomic nervous system (21,(23)(24)(25)(26) but also on the heart rate itself. This is analogous to the interpretation of the QT interval (4).…”

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confidence: 99%

Relation of Beat-to-Beat Variability to Heart Rate in Normal Sleeping Infants

et al. 1980

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SummaryThe relationship of beat-tebeat heart rate variability (delta RR) and instantaneous heart rate was studied in eight normal infants while asleep during the first four months of life. The sleep state (REM or quiet) was determined using neurophysiologic and behavioral criteria. The results of regression analyses indicated that the delta RR values were positively correlated with the instantaneous heart rate (RR intervals). The correlation coefficient range was 0.49 to 0.92 in quiet sleep and 0.50 to 0.93 in REM sleep. Regression analyses supported-a linear approximation of the delta RR to RR relation over the RR range investigated (400 to 520 msec). The median slope was 0.124 k REM Pad 0.117 in quiet sleep. The slopes of these linear functions were similar in both sleep states and at all ages. If beat-tebeat variability is to be used as an index of the integrity of the autonomic nervous system, these results suggest that delta RR be corrected for RR. A model is presented which relates the demonstrated positive correlation of delta RR to RR with the physiology of cardiac output control. SpeculationThe positive correlation of delta RR with RR is consistent with the view that beat-tebeat heart rate variability is a homeostatic mechanism required for control of cardiac output.Beat-to-beat or short-term heart rate variability (delta RR) is used for identification of fetal distress and is believed to reflect the integrity of the autonomic nervous system in the fetus and newborn (6, 11,18). Autonomic dysfunction may be manifested by decreased short-term variability as seen in hypoxic newborn infants at delivery (15) and in infants of mothers given parasympatholytic drugs (7,8,13,14).Short-term vrcriability may also prove to be a useful parameter for monitoring autonomic function during early infancy. However, as in the fetus (7, 8), short-term variability of the heart rate might be a function of the instantaneous heart rate (instantaneous heart rate defined as the inverse of the RR interval of the electrocardiotrocardiograms done after each study were normal. The procedures and objectives of the study were explained to the parents. and informed consent was obtained. A total of four or five studies, lasting one to two hr, were performed on each infant while it was asleep. Serial studies were performed during the first two wk of life and subsequently at monthly intervals through four months of age. Each study was done in a quiet laboratory environment after a usual midmorning feeding. MEASUREMENT OF THE RR INTERVALSElectrocardiogram surface electrodes were positioned on the chest to obtain a unidirectional polygraph recording with a single prominent R wave which had a sharp peak. Each RR interval of this wide-band electrocardiogram signal (0.5 to 2000 Hz) was measured with an accuracy of 200 p e c using a digital preprocessor designed in this laboratory (17). The data was carefully reviewed, and less than 0.1% of the 10,000 to 15,000 of each study RR intervals were rejected as artifact. SLEEP STAGINGSurface electrodes...

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“…In 1965 URBACH et al and RUDOLPH et al [35,39] described a loss of heart rate variability in severely ill neonates. In this study we investigated the correlation between instantaneous heart rate patterns and status diagnosis.…”

Section: Discussionmentioning

confidence: 99%