Maturation of the Cardiac Autonomic Nervous System Activity in Children and Adolescents.
Maturation of the Cardiac Autonomic Nervous System Activity in Children and Adolescents.
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儿童和青少年心脏自主神经系统活动的成熟。
DOI：
10.1161/jaha.120.017405
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发表时间：
2021-02-16
影响因子：
5.4
通讯作者：
FemNAT‐CD collaborators *
中科院分区：
文献类型：
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作者：
Harteveld LM;Nederend I;Ten Harkel ADJ;Schutte NM;de Rooij SR;Vrijkotte TGM;Oldenhof H;Popma A;Jansen LMC;Suurland J;Swaab H;de Geus EJC;FemNAT‐CD collaborators *
尽管人们对心脏自主神经活动的兴趣与日俱增，但对心脏自主神经的正常发育尚不完全清楚。主要目的是测定0.5~20岁健康患者心脏交感神经(SNS)和副交感神经系统(PNS)不同活动参数的成熟度。第二个目标是确定潜在的性别差异。5项涵盖0.5-20岁年龄范围的研究提供了心阻抗和心电图记录，从中收集了心率、不同的PNS参数(如呼吸性窦性心律失常)和SNS参数(射血前)。年龄趋势是通过12个年龄段的平均值和特定年龄的方差来计算的。年龄与所有参数的均值和方差的变化有关。三叉神经节的活性呈三次曲线变化，从婴儿期开始呈指数增长，在儿童期中期处于平台期，然后下降到青春期。SNS-活性呈现更线性的趋势，从婴儿期到青春期逐渐下降。男孩在11岁至15岁时SNS活性较高，而PNS活性在5岁和11岁至12岁时较高，女孩较早达到平台期水平。各年龄段个体间差异较大。SNS参数和对数转换的PNS参数的方差相当稳定。儿童时期心脏三叉神经节和三叉神经节的活动遵循不同的成熟轨迹。PNS-活性在儿童期中期呈三次曲线变化，呈平台期，而SNS-活性在0.5-20岁之间呈线性下降。尽管使用了大量样本，但考虑到巨大的个体差异，即使在狭窄的年龄段内，性别特定百分位数和百分位数标准值的临床应用也是适度的。
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. 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. 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.