Key result
Congenital heart disease is linked to persistent autonomic nervous system dysfunction before and after intervention.
Why the study?
Does congenital heart disease alter cardiac autonomic nervous control in pediatric patients?
Does congenital heart disease alter cardiac autonomic nervous control in pediatric patients?
This narrative review highlights that pediatric congenital heart disease is characterized by altered autonomic nervous system function, emphasizing the need for longitudinal studies to understand its role in long-term sequelae.
Answers are grounded in this paper and cite their sources.
Altered autonomic function in CHD may warrant monitoring; leaves open its prognostic role pending longitudinal studies.
Congenital heart disease is the most common congenital defect. During childhood, survival is generally good but, in adulthood, late complications are not uncommon. Abnormal autonomic control in children with congenital heart disease may contribute considerably to the pathophysiology of these long term sequelae. This narrative review of 34 studies aims to summarize current knowledge on function of the autonomic nervous system in children with a congenital heart defect. Large scale studies that measure both branches of the nervous system for prolonged periods of time in well-defined patient cohorts in various phases of childhood and adolescence are currently lacking. Pending such studies, there is not yet a good grasp on the extent and direction of sympathetic and parasympathetic autonomic function in pediatric congenital heart disease. Longitudinal studies in homogenous patient groups linking autonomic nervous system function and clinical outcome are warranted.
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Nederend et al. (2016) conducted a review in Pediatric Congenital Heart Disease. Congenital heart disease vs. Healthy controls was evaluated on Cardiac autonomic nervous system function (e.g., heart rate variability, pre-ejection period, baroreceptor sensitivity). Congenital heart disease is associated with altered sympathetic and parasympathetic autonomic nervous system function both before and after intervention, though extent and direction vary by defect and treatment.
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