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儿童和青少年神经心源性晕厥的自主神经功能

Autonomic function in children and adolescents with neurocardiogenic syncope.

作者信息

Longin E, Reinhard J, von Buch C, Gerstner Th, Lenz T, König S

机构信息

Children's Department, Vendsyssel Hospital, Bispengade 37, 9800, Hjoerring, Denmark.

出版信息

Pediatr Cardiol. 2008 Jul;29(4):763-70. doi: 10.1007/s00246-008-9198-z. Epub 2008 Feb 14.

Abstract

BACKGROUND

This study aimed to clarify whether children with neurocardiogenic syncope (NCS) differ from healthy control subjects in baseline heart rate variability (HRV) and in their response to orthostatic stress induced by active standing and tilt table.

METHODS

This study analyzed the difference between 55 children with a history of NCS or presyncopal symptoms (PS) and healthy control subjects. Measurements included short-term HRV during resting position, tilt table testing, and active standing. Time and frequency domain HRV parameters were computed.

RESULTS

Both the NCS and PS children differed significantly from healthy control subjects during resting position. During tilt table testing, nearly all NCS and PS subjects differed significantly from the control group in calculated HRV parameters. Moreover, for the low-frequency power and total power, the confidence intervals did not overlap.

CONCLUSIONS

The findings suggest that chronic autonomic differences exist between healthy children and patients with NCS and PS. These changes could be detected even by short-term HRV recordings. The tilt table maneuver provoked the most prominent differences between the groups. Low-frequency power and total power during tilt table testing helps to detect children with NCS.

摘要

背景

本研究旨在阐明神经心源性晕厥(NCS)患儿与健康对照者在基线心率变异性(HRV)以及对主动站立和倾斜试验诱发的直立位应激反应方面是否存在差异。

方法

本研究分析了55例有NCS病史或晕厥前症状(PS)的患儿与健康对照者之间的差异。测量包括静息位、倾斜试验和主动站立期间的短期HRV。计算时域和频域HRV参数。

结果

NCS患儿和PS患儿在静息位时与健康对照者均存在显著差异。在倾斜试验期间,几乎所有NCS和PS受试者在计算的HRV参数方面与对照组均存在显著差异。此外,对于低频功率和总功率,置信区间不重叠。

结论

研究结果表明,健康儿童与NCS和PS患者之间存在慢性自主神经差异。即使通过短期HRV记录也能检测到这些变化。倾斜试验在两组之间引发了最显著的差异。倾斜试验期间的低频功率和总功率有助于检测NCS患儿。

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