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早产儿成年人心率恢复的研究

Postexercise Heart Rate Recovery in Adults Born Preterm.

机构信息

Department of Chronic Disease Prevention, National Institute for Health and Welfare, Oulu and Helsinki, Finland; PEDEGO Research Unit, Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland.

Department of Chronic Disease Prevention, National Institute for Health and Welfare, Oulu and Helsinki, Finland; PEDEGO Research Unit, Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland.

出版信息

J Pediatr. 2019 Nov;214:89-95.e3. doi: 10.1016/j.jpeds.2019.06.056. Epub 2019 Aug 6.

Abstract

OBJECTIVE

To evaluate postexercise heart rate recovery (HRR) in adults born preterm.

STUDY DESIGN

We studied the association between preterm birth and postexercise HRR in 545 adults (267 women) at 23.3 years of age (range 19.9-26.3 years). One hundred three participants were born early preterm (<34 completed weeks), 178 late preterm (34-36), and 264 were full term (control group). HRR was calculated as change in heart rate (HR) 30 seconds and 60 seconds after cessation of submaximal step test and maximum HR slope during the first minute after.

RESULTS

Mean peak HR was 159.5 bpm in the early preterm (P = .16 with controls), 157.8 bpm in the late preterm (P = .56), and 157.0 bpm in the control group. Mean HRR 30 seconds after exercise was 3.2 bpm (95% CI 1.1-5.2) lower in the early preterm group and 2.1 bpm (0.3-3.8) lower in the late preterm group than the full term controls. Mean 60s HRR was 2.5 (-0.1 to 5.1) lower in the early preterm group and 2.8 bpm (0.6-4.9) lower in the late preterm group. Mean maximum slope after exercise was 0.10 beats/s (0.02-0.17) lower in the early preterm group and 0.06 beats/s (0.00-0.12) lower in the late preterm group.

CONCLUSIONS

Our results suggest reduced HRR after exercise in adults born preterm, including those born late preterm. This suggests altered reactivation of the parasympathetic nervous system, which may contribute to cardiovascular risk among adults born preterm.

摘要

目的

评估早产儿成年后的运动后心率恢复(HRR)。

研究设计

我们研究了 545 名成年人(267 名女性)在 23.3 岁(19.9-26.3 岁)时早产与运动后 HRR 之间的关系。103 名参与者为早期早产儿(<34 周),178 名晚期早产儿(34-36 周),264 名足月产(对照组)。HRR 计算为亚最大台阶试验停止后 30 秒和 60 秒时的心率(HR)变化,以及最大 HR 斜率在运动后第一分钟内的变化。

结果

早期早产儿的平均峰值 HR 为 159.5 bpm(与对照组相比,P =.16),晚期早产儿为 157.8 bpm(P =.56),对照组为 157.0 bpm。运动后 30 秒的平均 HRR 早期早产儿组低 3.2 bpm(95%CI 1.1-5.2),晚期早产儿组低 2.1 bpm(0.3-3.8)。早期早产儿组的 60s HRR 平均低 2.5 bpm(-0.1 至 5.1),晚期早产儿组低 2.8 bpm(0.6-4.9)。运动后最大斜率平均低 0.10 次/秒(0.02-0.17),早期早产儿组低 0.06 次/秒(0.00-0.12),晚期早产儿组低 0.06 次/秒(0.00-0.12)。

结论

我们的研究结果表明,早产儿成年后运动后的 HRR 降低,包括晚期早产儿。这表明副交感神经系统的重新激活发生改变,这可能导致早产儿成年后心血管风险增加。

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