Key result
Children with aortic valve stenosis had significantly lower heart rate variability, including reduced SDNN (127.8 ms vs 162.6 ms, p<0.001), compared to healthy controls.
Why the study?
Does aortic valve stenosis alter heart rate variability in children compared to healthy controls?
Observational (n=120)
Yes
Does aortic valve stenosis alter heart rate variability in children compared to healthy controls?
Children with aortic valve stenosis exhibit reduced heart rate variability indicating autonomic imbalance, with daytime SDNN reduction potentially signaling ventricular arrhythmia risk.
INTRODUCTION: The aim of our prospective study was to evaluate heart rate variability (HRV) in children with aortic valve stenosis (AS) and its relationship with left ventricular mass and peak transaortic valve pressure gradient (PG). MATERIAL AND METHODS: Sixty children with AS divided into 3 groups according to their PG and 60 healthy controls were studied. Holter ECG monitoring with time domain HRV analysis was performed. Left ventricular mass was calculated by echocardiography. RESULTS: Mean values of all HRV parameters were statistically significantly lower (p < 0.001) in children with AS than in controls (respectively: SDNN 127.8 ±28.2 ms; 162.6 ±38.0 ms, SDNN day 99.7 ±26.6 ms; 134.1 ±36.1 ms, SDNN night 99.9 ±32.8 ms; 123.4 ±45.7 ms, SDANN 112.2 ±27.7 ms; 142.4 ±34.6, SDNNi 62.2 ±16.2 ms; 75.9 ±21.6, RMSSD 39.6 ±12.1 ms; 50.3 ±16.7 ms, rMSSD day 33.6 ±10.9 ms; 43.1 ±14.7 ms, rMSSD night 49.8 ±18.1 ms; 64.4 ±24.9 ms, pNN50 16.4 ±9.5%; 23.5 ±11.7%, pNN50 day 12.0 ±8.5%; 18.4 ±10.7%, pNN50 night; 26.5 ±14.8%; 36.4 ±17.4%. No significant differences between the mean values of HRV parameters in children with different PG and with and without myocardial hypertrophy were found. In children with AS and ventricular arrhythmia SDNN day was significantly lower (p < 0.05) compared to patients without arrhythmia (94.9 ±22.1 ms vs. 109.3 ±22.5 ms). CONCLUSIONS: In children with AS the balance of the autonomic nervous systemic disturbed which manifests in an increase in sympathetic and decrease in parasympathetic activity. Transaortic valve pressure gradient and myocardial hypertrophy do not influence the HRV. The SDNN reduction during the day period may indicate the risk of ventricular arrhythmia in children with AS.
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Werner et al. (2013) conducted an observational in Aortic valve stenosis (n=120). Aortic valve stenosis vs. Healthy controls was evaluated on SDNN (standard deviation of all filtered R-R intervals) (p=<0.001). Children with aortic valve stenosis had significantly lower heart rate variability, including reduced SDNN (127.8 ms vs 162.6 ms, p<0.001), compared to healthy controls.
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