Circadian patterns of heart rate variability in fetal sheep after hypoxia-ischaemia: A biomarker of evolving brain injury.

Autor: Lear CA; Department of Physiology, Fetal Physiology and Neuroscience Group, The University of Auckland, Auckland, New Zealand., Maeda Y; Department of Physiology, Fetal Physiology and Neuroscience Group, The University of Auckland, Auckland, New Zealand.; The Department of Obstetrics and Gynaecology, Mie University, Mie, Japan., King VJ; Department of Physiology, Fetal Physiology and Neuroscience Group, The University of Auckland, Auckland, New Zealand., Dhillon SK; Department of Physiology, Fetal Physiology and Neuroscience Group, The University of Auckland, Auckland, New Zealand., Beacom MJ; Department of Physiology, Fetal Physiology and Neuroscience Group, The University of Auckland, Auckland, New Zealand., Gunning MI; Department of Physiology, Fetal Physiology and Neuroscience Group, The University of Auckland, Auckland, New Zealand., Lear BA; Department of Physiology, Fetal Physiology and Neuroscience Group, The University of Auckland, Auckland, New Zealand., Davidson JO; Department of Physiology, Fetal Physiology and Neuroscience Group, The University of Auckland, Auckland, New Zealand., Stone PR; The Department of Obstetrics and Gynaecology, The University of Auckland, Auckland, New Zealand., Ikeda T; The Department of Obstetrics and Gynaecology, Mie University, Mie, Japan., Gunn AJ; Department of Physiology, Fetal Physiology and Neuroscience Group, The University of Auckland, Auckland, New Zealand., Bennet L; Department of Physiology, Fetal Physiology and Neuroscience Group, The University of Auckland, Auckland, New Zealand.
Jazyk: angličtina
Zdroj: The Journal of physiology [J Physiol] 2023 Jul 11. Date of Electronic Publication: 2023 Jul 11.
DOI: 10.1113/JP284560
Abstrakt: Hypoxia-ischaemia (HI) before birth is a key risk factor for stillbirth and severe neurodevelopmental disability in survivors, including cerebral palsy, although there are no reliable biomarkers to detect at risk fetuses that may have suffered a transient period of severe HI. We investigated time and frequency domain measures of fetal heart rate variability (FHRV) for 3 weeks after HI in preterm fetal sheep at 0.7 gestation (equivalent to preterm humans) until 0.8 gestation (equivalent to term humans). We have previously shown that this is associated with delayed development of severe white and grey matter injury, including cystic white matter injury (WMI) resembling that observed in human preterm infants. HI was associated with suppression of time and frequency domain measures of FHRV and reduced their circadian rhythmicity during the first 3 days of recovery. By contrast, circadian rhythms of multiple measures of FHRV were exaggerated over the final 2 weeks of recovery, mediated by a greater reduction in FHRV during the morning nadir, but no change in the evening peak. These data suggest that the time of day at which FHRV measurements are taken affects their diagnostic utility. We further propose that circadian changes in FHRV may be a low-cost, easily applied biomarker of antenatal HI and evolving brain injury. KEY POINTS: Hypoxia-ischaemia (HI) before birth is a key risk factor for stillbirth and probably for disability in survivors, although there are no reliable biomarkers for antenatal brain injury. In preterm fetal sheep, acute HI that is known to lead to delayed development of severe white and grey matter injury over 3 weeks, was associated with early suppression of multiple time and frequency domain measures of fetal heart rate variability (FHRV) and loss of their circadian rhythms during the first 3 days after HI. Over the final 2 weeks of recovery after HI, exaggerated circadian rhythms of frequency domain FHRV measures were observed. The morning nadirs were lower with no change in the evening peak of FHRV. Circadian changes in FHRV may be a low-cost, easily applied biomarker of antenatal HI and evolving brain injury.
(© 2023 The Authors. The Journal of Physiology published by John Wiley & Sons Ltd on behalf of The Physiological Society.)
Databáze: MEDLINE
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