Maturation of the Cardiac Autonomic Nervous System Activity in Children and Adolescents
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Published:2021-02-16
Issue:4
Volume:10
Page:
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ISSN:2047-9980
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Container-title:Journal of the American Heart Association
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language:en
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Short-container-title:JAHA
Author:
Harteveld Lisette M.1ORCID, Nederend Ineke12ORCID, ten Harkel Arend D. J.1ORCID, Schutte Nienke M.2ORCID, de Rooij Susanne R.34ORCID, Vrijkotte Tanja G. M.4ORCID, Oldenhof Helena5ORCID, Popma Arne5ORCID, Jansen Lucres M. C.5ORCID, Suurland Jill6, Swaab Hanna6ORCID, de Geus Eco J. C.2ORCID, Prätzlich Martin, Ackermann Katharina, Baker Rosalind, Batchelor Molly, Baumann Sarah, Bernhard Anka, Clanton Roberta, Dikeos Dimitris, Dochnal Roberta, Fehlbaum Lynn Valérie, Fernández‐Rivas Aranzazu, Gonzalez Karen, González de Artaza‐Lavesa Maider, Guijarro Silvina, Gundlach Malou, Herpertz‐Dahlmann Beate, Hervas Amaia, Kersten Linda, Kohls Gregor, Konsta Angeliki, Lazaratou Helen, Kerexeta‐Lizeaga Iñaki, Martinelli Anne, van Nimwegen Tisse, Puzzo Ignazio, Raschle Nora Maria, Rogers Jack, Siklósi Réka, Smaragdi Areti, Steppan Martin, De Brito Stephane, Fairchild Graeme, Kieser Meinhard, Konrad Kerstin, Freitag Christine, Stadler Christina
Affiliation:
1. Department of Pediatric Cardiology Leiden University Medical Center Leiden The Netherlands 2. Department of Biological Psychology Faculty of Human Behavioral and Movement Sciences Vrije Universiteit AmsterdamAmsterdam Public Health Research Institute Amsterdam The Netherlands 3. Department of Clinical Epidemiology, Biostatistics and Bioinformatics Amsterdam University Medical CenterAcademic Medical Center Amsterdam The Netherlands 4. Department of Public Health Amsterdam Public Health Research InstituteAmsterdam University Medical CenterUniversity of Amsterdam Amsterdam The Netherlands 5. Department of Child and Adolescent Psychiatry Amsterdam University Medical CenterVU University Medical Centre Amsterdam The Netherlands 6. Department of Clinical Child and Adolescent Studies and Leiden Institute for Brain and Cognition Leiden University Leiden The Netherlands
Abstract
Background
Despite the increasing interest in cardiac autonomic nervous activity, the normal development is not fully understood. The main aim was to determine the maturation of different cardiac sympathetic‐(SNS) and parasympathetic nervous system (PNS) activity parameters in healthy patients aged 0.5 to 20 years. A second aim was to determine potential sex differences.
Methods and Results
Five studies covering the 0.5‐ to 20‐year age range provided impedance‐ and electrocardiography recordings from which heart rate, different PNS‐parameters (eg, respiratory sinus arrhythmia) and an SNS‐parameter (pre‐ejection period) were collected. Age trends were computed in the mean values across 12 age‐bins and in the age‐specific variances. Age was associated with changes in mean and variance of all parameters. PNS‐activity followed a cubic trend, with an exponential increase from infancy, a plateau phase during middle childhood, followed by a decrease to adolescence. SNS‐activity showed a more linear trend, with a gradual decrease from infancy to adolescence. Boys had higher SNS‐activity at ages 11 to 15 years, while PNS‐activity was higher at 5 and 11 to 12 years with the plateau level reached earlier in girls. Interindividual variation was high at all ages. Variance was reasonably stable for SNS‐ and the log‐transformed PNS‐parameters.
Conclusions
Cardiac PNS‐ and SNS‐activity in childhood follows different maturational trajectories. Whereas PNS‐activity shows a cubic trend with a plateau phase during middle childhood, SNS‐activity shows a linear decrease from 0.5 to 20 years. Despite the large samples used, clinical use of the sex‐specific centile and percentile normative values is modest in view of the large individual differences, even within narrow age bands.
Publisher
Ovid Technologies (Wolters Kluwer Health)
Subject
Cardiology and Cardiovascular Medicine
Cited by
37 articles.
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