Key result
Asthma in children and adolescents was associated with significantly lower long-term standard deviation of normal-to-normal sinus R-R intervals compared to healthy controls (SMD -0.46; 95% CI -0.79 to -0.14; p<0.005).
Why the study?
Asthma is associated with abnormal autonomic function, but its impact on heart rate variability in children and adolescents needed systematic investigation.
Does asthma affect heart rate variability in children and adolescents?
Meta-Analysis
Does asthma affect heart rate variability in children and adolescents?
Standardized Mean Difference: -0.46 (95% CI -0.79–-0.14)
p-value: p=< 0.005
Asthma is associated with reduced heart rate variability and altered sympathetic modulation in children and adolescents.
Asthma-linked HRV changes in youth signal autonomic involvement; leaves open prospective validation before clinical monitoring use.
Purpose Asthma is associated with abnormal autonomic function, and heart rate variability is considered a simple, accurate, and noninvasive tool for monitoring the autonomic system. Thus, the aim of this study was to investigate the impact of asthma on heart rate variability in children and adolescents. Methods This systematic review of observational studies and clinical trials evaluated heart rate variability in children and adolescents with asthma compared to healthy controls. The data were extracted independently by two reviewers. The quality of the selected articles was assessed using Agency for Health Care Research and Quality indicators. Random effects meta‐analysis was performed for each outcome, with the effect size reported as standardized mean difference. Results Fifteen studies were included, of which five were classified as having high methodological quality. In the meta‐analysis, long‐term recording of the standard deviation of all normal‐to‐normal sinus R‐R intervals differed significantly between groups (standardized mean difference [SMD] = −0.46 [95% confidence interval {CI}: −0.79 to −0.14], p < 0.005, I2 = 0%). Moreover, R‐R intervals (long‐term) were significantly shorter in asthmatic children than controls (SMD = −0.47 [95% CI: −0.68 to −0.25], p < 0.0001, I2 = 0). There were no significant differences between adjacent normal R‐R intervals that exceed 50 ms (long‐term) and the root mean square of successive differences between normal sinus R‐R intervals (short‐term). Regarding frequency‐domain variables, long‐term low frequency measurements differed significantly between groups (SMD = −0.34 [95% CI: −0.58 to −0.10], p < 0.005, I2 = 15%). There were no differences in high frequency measurements or in the ratio between low/high frequency powers (short‐ or long‐term) between groups. Conclusion The results confirm the impact of asthma on heart rate variability in children and adolescents, indicating lower heart rate variability and sympathetic modulation.
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Schiwe et al. (2023) conducted a meta-analysis in Asthma. Asthma vs. Healthy controls was evaluated on Long-term recording of the standard deviation of all normal-to-normal sinus R-R intervals (SMD -0.46, 95% CI -0.79 to -0.14, p=< 0.005). Asthma in children and adolescents was associated with significantly lower long-term standard deviation of normal-to-normal sinus R-R intervals compared to healthy controls (SMD -0.46; 95% CI -0.79 to -0.14; p<0.005).
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