Heart rate variability in infants with central coordination disturbance.
Despite a remarkable medical progress in the field of Developmental Medicine and Child Neurology, early identification of infants at risk for permanent motor disabilities still presents challenge for both clinicians and researchers. As an indicator of cardiac autonomic control, it was shown that heart rate variability (HRV) might reflect not only sympathetic or parasympathetic activity but also functional integrity of the central nervous system (CNS). Furthermore a pattern of HRV was demonstrated to correlate with motor developmental outcome in high risk infants. The purpose of this study was to analyze the clinical usefulness as well as predictive value of time-domain HRV parameters in infants with central coordination disturbance. The study included 35 infants with central coordination disturbance and 37 healthy age and sex-matched controls. Time-domain HRV indices were analyzed from 24-h electrocardiography recordings. We found significantly lower values of SDNN, SDANN and RMSSD parameters in infants with central coordination disturbance compared to controls. Additionally, logistic regression analyses demonstrated independent predictive value of parameters SDNN and SDANN in infants who subsequently developed cerebral palsy (CP). By performing receiver operating characteristic (ROC) analyses, the optimal cut-off value of SDNN<=48ms predicted CP with a sensitivity of 68.7% (95% CI 41.4-88.9) and specificity of 84.2% (95 CI 60.4-96.4) while the optimal cut-off value of SDANN<=41ms predicted CP with a sensitivity of 87.5% (95% CI 61.6-98.1) and specificity of 57.9% (95 CI 33.5-79.7). We are in opinion that time domain HRV analysis could be helpful clinically as well as a prognostic tool in infants with central coordination disturbance.
Clinic of Pediatrics, Clinical Center, Nis, Serbia. bojko968@gmail.com <bojko968@gmail.com>
Bojko
B
Bjelakovic
Stevan
S
Ilic
Lidija
L
Dimitrijevic
Branislav
B
Milovanovic
Gordana
G
Kostic
Ljiljana
L
Bjelakovic
Stevo
S
Lukic
D001145:Arrhythmias, Cardiac / Q000150:complications / Q000503:physiopathology*; D002320:Cardiovascular Physiological Phenomena; D002547:Cerebral Palsy / Q000150:complications / Q000503:physiopathology*; D015716:Electrocardiography, Ambulatory / Q000379:methods / Q000706:statistics & numerical data; D005260:Female; D006334:Heart Function Tests; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D007223:Infant; D016015:Logistic Models; D008297:Male; D011237:Predictive Value of Tests; D011379:Prognosis; D012372:ROC Curve; D013564:Sympathetic Nervous System / Q000502:physiology