[Electrocardiographic signs of autonomic imbalance in infants with congenital heart defects].
Infants with congenital heart disease (CHD) and heart failure have elevated plasma norepinephrine levels (NE) as a sign for sympathetic activation. We analysed ECGs of 64 infants with CHD and found normal heart rates on average in four groups split up according to their NE. Mean heart rate in Holter ECGs was significantly reduced in infants with low NE (below 350 ng/l) but normal in the other groups (NE < 350 ng/l: 121 +/- 10/min; NE = 350-700 ng/l: 139 +/- 11/min; NE = 700-1300 ng/l: 142 +/- 13/min; NE > 1300 ng/l: 135 +/- 12/min). An analysis of heart rate variability in a subgroup of 25 infants showed significantly reduced values in patients with elevated NE in comparison to 70 healthy infants. Significantly reduced frequency domain measures in infants with elevated NE but also normal NE are evidence for a high diagnostic sensitivity of an analysis of heart rate variability for autonomic imbalance with sympathetic activation and parasympathetic withdrawal in infants with CHD.
Buchhorn
R
R
Abteilung Pädiatrische Kardiologie Universitätsklinikum Göttingen Robert-Koch-Str. 40 37075 Göttingen, Germany. rbuchho@gwdg.de
Geesmann
M
M
Bürsch
J
J
D000367:Age Factors; D002316:Cardiotonic Agents / Q000627:therapeutic use; D003627:Data Interpretation, Statistical; D004077:Digoxin / Q000627:therapeutic use; D004232:Diuretics / Q000627:therapeutic use; D004562:Electrocardiography; D015716:Electrocardiography, Ambulatory; D004837:Epinephrine / Q000097:blood; D006330:Heart Defects, Congenital / Q000097:blood / Q000188:drug therapy / Q000503:physiopathology*; D006339:Heart Rate; D006439:Hemodynamics; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D009638:Norepinephrine / Q000097:blood*; D011433:Propranolol / Q000627:therapeutic use; D014665:Vasodilator Agents / Q000627:therapeutic use
D002316:Cardiotonic Agents; D004232:Diuretics; D014665:Vasodilator Agents; D004077:Digoxin; D011433:Propranolol; D009638:Norepinephrine; D004837:Epinephrine