Universidade Federal de São Paulo (UNIFESP), Departamento de Medicina, Disciplina de Cardiologia, São Paulo, SP, Brazil; Universidad Nacional de La Matanza (UNLaM), Departamento de Ciencias de la Salud, Kinesiología y Fisiatría, San Justo, BA, Argentina.
Universidade de São Paulo (USP), Faculdade de Medicina, Programa de Pós-graduação Ciências da Reabilitação, São Paulo, SP, Brazil.
Auton Neurosci. 2018 Sep;213:23-33. doi: 10.1016/j.autneu.2018.05.006. Epub 2018 May 12.
Down syndrome (DS) results in many changes, including dysfunction in cardiac autonomic modulation. Heart rate variability (HRV) analysis evaluates the autonomic function and it is a predictor of adverse cardiovascular events.
To present results of a systematic review and a meta-analysis about heart rate variability in individuals with DS.
A systematic review was performed on PubMed, PubMed Central and Web of science databases. We included articles that exhibited all the terms: "Down Syndrome", "heart rate variability", "autonomic nervous system", "autonomic dysfunction" and "cardiac autonomic modulation". We conducted the meta-analysis to compare "DS" to "controls" during rest. Random effects models were used, as were appropriate tests for heterogeneity.
From 271 studies, 13 were included in our review. These are conducted with volunteers from a wide age range, of either gender, and not taking medications. Meta-analysis displayed that there were no significant differences between the groups at rest, except the RMSSD, which revealed a significant (Z = -2.80, p = 0.005) main effect (Hedge's g = -0.55, 95% CI [-0.93; -0.16]), indicating difference in individuals with DS compared with controls.
There is autonomic dysfunction in individuals with DS, which may or may not be expressed at rest, but it is usually demonstrated in an autonomic task. Meta-analysis specified that there was no significant alteration between DS and the controls during rest, except RMSSD index which was lower in DS than controls.
CRD42017068647.
唐氏综合征（DS）会导致许多变化，包括心脏自主调节功能障碍。心率变异性（HRV）分析评估自主功能，是预测不良心血管事件的指标。
呈现关于 DS 个体的心率变异性的系统评价和荟萃分析结果。
在 PubMed、PubMed Central 和 Web of Science 数据库中进行了系统评价。我们纳入了展示所有术语的文章：“唐氏综合征”、“心率变异性”、“自主神经系统”、“自主功能障碍”和“心脏自主调节”。我们进行了荟萃分析，以比较“DS”与“对照”在休息时的情况。使用随机效应模型，并进行适当的异质性检验。
从 271 项研究中，有 13 项纳入了我们的综述。这些研究都是针对来自广泛年龄范围、性别和未服用药物的志愿者进行的。荟萃分析显示，两组在休息时没有显著差异，除了 RMSSD，它显示出显著的（Z = -2.80，p = 0.005）主要效应（Hedge's g = -0.55，95%CI [-0.93; -0.16]），表明 DS 个体与对照组之间存在差异。
DS 个体存在自主功能障碍，这种障碍可能在休息时表现出来，也可能不表现出来，但通常在自主任务中表现出来。荟萃分析特别指出，在休息时，DS 与对照组之间没有显著的变化，除了 RMSSD 指数，DS 组的 RMSSD 指数低于对照组。
CRD42017068647。
