Lubocka Paulina, Sabiniewicz Robert
Department of Pediatric Cardiology and Congenital Heart Disease, Medical University of Gdańsk, Gdańsk, Poland.
Front Cardiovasc Med. 2021 May 20;8:643846. doi: 10.3389/fcvm.2021.643846. eCollection 2021.
Respiratory sinus arrhythmia (RSA) is associated with better health in children. The study was conducted to analyze the trajectory of RSA in 10-year-olds. A follow-up study on 120 healthy children (62 boys) aged 10.7 ± 0.5 years consisted of a standard 12-lead electrocardiogram, measurements of height, weight and blood pressure. The protocol was repeated after 3 years. Assessment of RSA based on semi-automatic measurements of RR intervals included: the difference between the longest and shortest RR interval duration (pvRSA), the root mean square of differences between successive RR intervals (RMSSD), the standard deviation of the RR interval length (SDNN) and their equivalents corrected for heart rate (RMSSDc and SDNNc). A the first visit 61.7% of children presented with RSA; 51.7% 3 years later. 23.3% of them had RSA only on the first examination; 13.3% only on the second one. The pvRSA, RMSSD, and SDNN measured in 2019 did not differ significantly from their 2016 equivalents ( > 0.05). The decline in RSA defined by RMSSD was noted in 52.5% of children and in 54.2% when defined by SDNN. The corrected values decreased in 68.3 and 64.2% of the participants for RMSSDc and SDNNc, respectively. The students with RSA at both visits had lower heart rate ( < 0.001) and systolic blood pressure ( = 0.010) compared to those with rhythmic electrocardiograms. RSA in children is changeable, though its measurable indices should be adjusted to heart rate.
呼吸性窦性心律不齐（RSA）与儿童更健康的身体状况相关。本研究旨在分析10岁儿童RSA的变化轨迹。对120名年龄为10.7±0.5岁的健康儿童（62名男孩）进行了一项随访研究，包括标准12导联心电图检查、身高、体重和血压测量。3年后重复该方案。基于RR间期半自动测量对RSA的评估包括：最长和最短RR间期持续时间之差（pvRSA）、连续RR间期之差的均方根（RMSSD）、RR间期长度的标准差（SDNN）及其心率校正值（RMSSDc和SDNNc）。首次就诊时，61.7%的儿童存在RSA；3年后这一比例为51.7%。其中23.3%仅在首次检查时存在RSA；13.3%仅在第二次检查时存在。2019年测量的pvRSA、RMSSD和SDNN与其2016年的测量值相比无显著差异（>0.05）。以RMSSD定义的RSA下降在52.5%的儿童中出现，以SDNN定义时这一比例为54.2%。RMSSDc和SDNNc的校正值分别在68.3%和64.2%的参与者中下降。与心电图节律正常的学生相比，两次就诊时均存在RSA的学生心率更低（<0.001），收缩压更低（=0.010）。儿童的RSA是可变的，不过其可测量指标应根据心率进行调整。
