Indicators of heart rate variability in children with acute bronchopulmonary diseases

Holter electrocardiogram (ECG) monitoring is a modern method for diagnosing of the cardiovascular system state and allows for a deeper study of the risks of comorbidity on its part in respiratory diseases. Among a significant number of indicators of the method, heart rate variability stands out as a marker of the balance between the activity of the sympathetic and parasympathetic parts of the autonomic nervous system. In children with acute respiratory diseases, it is important and poorly studied assessment of the autonomic balance and the degree of influence of this pathology on the autonomic functions of the heart. Aim - to analyze the features of heart rhythm variability and its relationship with autonomic innervation in children with acute respiratory diseases. Materials and methods. 50 children (18 children with acute bronchitis, 12 children with pneumonia and 20 clinically healthy individuals of the control group) were examined. The functional state of the cardiovascular system was determined using office blood pressure measurement and Holter ECG monitoring. The ECG was recorded for 5 minutes, followed by an assessment of heart rate variability. Results. The paper analyzes the indicators of heart rate variability, which have a clear physiological basis, such as the measure of the central tendency of the RR interval, indicators of variance, heart rhythm concentration, and the level of parasympathetic effects on the heart rhythm. A significant difference between the data obtained in the experimental groups relative to the control group was established, and a shift in the autonomic balance towards sympathetic tone was revealed, and in children with acute bronchitis these changes are greater than in patients with pneumonia. Conclusions. Assessment of the autonomic nervous system balance using Holter ECG monitoring with a short recording is a modern method for diagnosing its disorders. In respiratory diseases, the most sensitive indicators are heart rhythm concentration, the level of parasympathetic effects on heart rhythm and spectral indicators of heart rate variability. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.