Heart rate complexity in response to upright tilt in persons with Down syndrome
Heart rate complexity in response to upright tilt in persons with Down syndrome
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DOI：
10.1016/j.ridd.2011.08.015
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发表时间：
2011-11-01
影响因子：
3.1
通讯作者：
Fernhall, Bo
中科院分区：
文献类型：
--
作者：
Agiovlasitis, Stamatis;Baynard, Tracy;Fernhall, Bo
唐氏综合征（DS）患者对交感神经兴奋的自主神经反应发生改变。心脏自主调节可以用心率（HR）复杂性来检查，心率复杂性与心血管风险唯一相关。本研究探讨了被动直立倾斜的HR复杂性的反应是否与DS患者和非DS患者不同，以及这种反应的潜在组间差异是否由体重指数（BMI）的差异引起。记录16例DS患者（女8例，男8例）和16例非DS患者（女8例，男8例）仰卧休息10 min和直立倾斜10 min时的心电图。对于每名参与者，分析了每种条件下的550个连续、稳态和无异位R-R间期。因变量为近似熵、关联维数、StatAv和平均R-R间期。对于倾斜，DS参与者的近似熵和关联维数的变化减少（p < 0.05）。这些差异是由DS参与者的BMI较高解释的。DS患者的StatAv增加（p < 0.05），而无DS患者的StatAv保持不变，即使在控制BMI的情况下。R-R间期的反应在组间无差异。在静息状态下，各组之间的变量均无差异。因此，DS患者在直立倾斜时HR复杂性的降低幅度小于无DS患者，部分原因是他们的BMI较高。静息HR复杂性在有DS和没有DS的人之间没有差异。这些结果可能对DS患者的心血管风险有影响。(C)2011爱思唯尔有限公司保留所有权利。
People with Down syndrome (DS) show altered autonomic response to sympathoexcitation. Cardiac autonomic modulation may be examined with heart rate (HR) complexity which is associated uniquely with cardiovascular risk. This study examined whether the response of HR complexity to passive upright tilt differs between persons with and without DS and whether potential between-group differences in this response are accounted for by differences in body mass index (BMI). The electrocardiogram of 16 persons with DS (8 women, 8 men) and 16 persons without DS (8 women, 8 men) was recorded during 10 min of supine rest and 10 min of upright tilt. For each participant, 550 continuous, steady state, and ectopy-free R-R intervals under each condition were analyzed. Dependent variables were approximate entropy, correlation dimension, StatAv, and the mean R-R interval. In response to tilt, changes in approximate entropy and correlation dimension were reduced in participants with DS (p < 0.05). These differences were explained by higher BMI in participants with DS. StatAv increased in persons with DS (p < 0.05) and stayed the same in those without DS even when controlling for BMI. The response of R-R interval did not differ between groups. None of the variables differed between groups at rest. Therefore, people with DS show smaller decrease in HR complexity in response to upright tilt than people without DS partially due to their higher BMI. Resting HR complexity does not differ between persons with and without DS. These results may have implications for cardiovascular risk in people with DS. (C) 2011 Elsevier Ltd. All rights reserved.