Biến Đổi Nhịp Tim Ngắn Hạn Trong Một Mẫu Dân Số 10 Tuổi

Pediatric Cardiology - Tập 36 - Trang 41-48 - 2014
Denise C. Jarrin1, Jennifer J. McGrath2, Paul Poirier3, Louise Séguin4, Richard E. Tremblay5,6,7,8, Jacques Y. Montplaisir9,10, Gilles Paradis11, Jean R. Séguin8,9
1École de psychologie, Université Laval, Centre d’étude des troubles du sommeil, Centre de recherche de l’Institut universitaire en santé mentale de Québec, Québec, Canada
2Pediatric Public Health Psychology Laboratory, Department of Psychology, Concordia University, Montréal, Canada
3Faculté de pharmacie, Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, Québec, Canada
4Département de médecine sociale et préventive, Université de Montréal, Montréal, Canada
5Departments of Psychology and Pediatrics, Université de Montréal, Montréal, Canada
6School of Public Health and Population Science, University College Dublin, Dublin, Ireland
7L’Institut national de la santé et de la recherche médicale (INSERM) U669, Paris, France
8Centre de Recherche du CHU Ste-Justine, Montréal, Canada
9Department of Psychiatry, Université de Montréal, Montréal, Canada
10Centre d’études avancé de médicine du sommeil, Hopital du Sacré Coeur, Montréal, Canada
11Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Canada

Tóm tắt

Biến đổi nhịp tim (HRV) là một chỉ số định lượng không xâm lấn về chức năng thần kinh tự trị của tim được lấy từ các ghi chép điện tâm đồ (ECG) liên tục. Các giá trị HRV chuẩn và các yếu tố phát triển chưa được thiết lập trong các quần thể nhi khoa. Mục tiêu là đưa ra các giá trị HRV ở miền thời gian và tần số cho một mẫu trẻ em dựa trên quần thể. Trẻ em từ 9–11 tuổi (N = 1.036) đã tham gia sàng lọc sức khỏe tim mạch trong Nghiên cứu Dài hạn Phát triển Trẻ em Québec. Các y tá đã đo các thông số nhân trắc (chiều cao, trọng lượng) và trẻ em đã đeo máy Holter di động để ghi lại liên tục một tín hiệu ECG. Các biến HRV bao gồm các biến miền thời gian (SDNN, pNN50, RMSSD, SDANN) và miền tần số (HF, LF, tỷ lệ LF/HF). Các giá trị HRV chuẩn, được phân tầng theo tuổi, giới tính và nhịp tim, đã được trình bày. Nhịp tim cao hơn (β_avg = −0,60, R_avg² = 0,39), sự trưởng thành dậy thì (β_avg = −0,11, R_avg² = 0,01), thời gian ghi ECG muộn hơn (β_avg = −0,19, R_avg² = 0,07) và huyết áp tâm trương cao hơn (β_avg = −0,11, R_avg² = 0,01) có liên quan đáng kể đến việc giảm HRV ở trẻ em 10 tuổi. Các giá trị HRV chuẩn cho phép các chuyên gia lâm sàng theo dõi, mô tả và thiết lập các hệ thống phân loại bệnh nhi khoa trong chăm sóc chính và các thiết lập nghiên cứu, điều này có thể cải thiện việc điều trị các bệnh liên quan đến HRV ở trẻ em. Bằng cách hiểu rõ hơn các giá trị hiện có, khả năng áp dụng thực tiễn của HRV trong số các chuyên gia lâm sàng sẽ được nâng cao. Cuối cùng, các yếu tố phát triển (ví dụ, tuổi dậy thì) và quy trình (ví dụ, thời gian ghi) đã được xác định, sẽ cải thiện các quy trình ghi và giải thích kết quả.

Từ khóa

#biến đổi nhịp tim #HRV #nhi khoa #sức khỏe tim mạch #điện tâm đồ

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Pediatric Cardiology

Tập 36

41-48

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