Patent ductus arteriosus in preterm infants is associated with cardiac autonomic alteration and predominant parasympathetic stimulation
| Autor: | Sabrina Goudjil, Guy Kongolo, André Léké, Fatiha Imestouren, Ghida Ghostine, Fabrice Wallois, Christèle Chazal |
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| Rok vydání: | 2013 |
| Předmět: |
Male
congenital hereditary and neonatal diseases and abnormalities education Hemodynamics Stimulation Infant Premature Diseases Parasympathetic Nervous System Ductus arteriosus medicine Humans Heart rate variability Ductus Arteriosus Patent Balance (ability) business.industry Infant Newborn Obstetrics and Gynecology Gestational age Heart Autonomic nervous system medicine.anatomical_structure Case-Control Studies Anesthesia Pediatrics Perinatology and Child Health Circulatory system Female business Infant Premature |
| Zdroj: | Early Human Development. 89:631-634 |
| ISSN: | 0378-3782 |
| DOI: | 10.1016/j.earlhumdev.2013.04.008 |
| Popis: | Background Hemodynamic disorders in patent ductus arteriosus (PDA) may alter the stimulation of the autonomic nervous system. Aim The objective of this study was to analyze the orthosympathetic–parasympathetic balance in preterm infants with PDA. Study design and subjects Patients were included from consecutive admissions to Amiens University Hospital from 2009 to 2011. We defined a PDA group and a Control group (echographic criteria). For each patient, three 4-minutes segments of ECG were recorded during quiet sleep and the RR chronologic series were extracted, and spectral (Fourier Transform) and time-domain analyses were performed. For each parameter of heart rate variability (HRV), average of three measures was determined and analysed. Results Forty-four patients were included for analysis. The total HRV power, LF/HF ratio and SDNN were lower in the PDA group (n = 22, gestational age 28.2 w ± 1.9) than in the Control group (n = 22, gestational age 28.8 w ± 2). The decrease in LF power destabilized the autonomic balance in favour of parasympathetic stimulation. After adjustment for postconceptional age, PDA was still associated with parameters of autonomic neural stimulation. Conclusion These results suggest association of PDA with predominance of parasympathetic stimulation in preterm infants. The mechanisms of homeostasis in patients with PDA are very complex and involve both circulatory adaptations and control by autonomic pathway. If confirmed, our results could be interesting for future researches aiming to verify the interest of new targeted therapies for the management of PDA. |
| Databáze: | OpenAIRE |
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