Intra-Individual Relationship between Heart Rate Variability and the Underlying Heart Rate in Children and Adolescents

Authors

ŠIŠÁKOVÁ Martina HELÁNOVÁ Kateřina HNATKOVA Katerina ANDRŠOVÁ Irena NOVOTNÝ Tomáš MALÍK Marek

Year of publication 2024
Type Article in Periodical
Magazine / Source Journal of Clinical Medicine
MU Faculty or unit

Faculty of Medicine

Citation
Web https://www.mdpi.com/2077-0383/13/10/2897
Doi http://dx.doi.org/10.3390/jcm13102897
Keywords paediatric population; heart rate variability; heart rate; regression slope; age; sympatho-vagal balance
Description Background/Objective: The relationship between heart rate and heart rate variability (HRV) indices has been repeatedly studied in adults but limited data are available on the relationship in paediatric populations. Methods: Continuous 12-lead electrocardiograms were recorded in 1016 healthy children and adolescents (534 females) aged 4 to 19 years during postural manoeuvres with rapid changes between 10-min positions of supine -> sitting -> standing -> supine -> standing -> sitting -> supine. In each position, the averaged RR interval was measured together with four HRV indices, namely the SDNN, RMSSD, quasi-normalised high-frequency components (qnHF), and the proportions of low- and high-frequency components (LF/HF). In each subject, the slope of the linear regression between the repeated HRV measurements and the corresponding RR interval averages was calculated. Results: The intra-subject regression slopes, including their confidence intervals, were related to the age and sex of the subjects. The SDNN/RR, RMSSD/RR, and qnHF/RR slopes were significantly steeper (p < 0.001) and the (LF/HF)/RR slopes were significantly shallower (p < 0.001) in younger children compared to older children and adolescents. Conclusions: The study suggests that sympathetic and vagal influences on heart rate are present in both younger and older children. With advancing age, the sympatho-vagal balance gradually develops and allows the vagal control to suppress the sympathetic drive towards higher heart rates seen in younger age children.

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