Maturation of the Cardiac Autonomic Nervous System Activity in Children and Adolescents

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • FemNAT‐CD collaborators * - (Author)
  • Leiden University Medical Centre (LUMC)
  • Vrije Universiteit Amsterdam (VU)
  • University of Amsterdam
  • Leiden University

Abstract

Background Despite the increasing interest in cardiac autonomic nervous activity, the normal development is not fully understood. The main aim was to determine the maturation of different cardiac sympathetic-(SNS) and parasympathetic nervous system (PNS) activity parameters in healthy patients aged 0.5 to 20 years. A second aim was to determine potential sex differences. Methods and Results Five studies covering the 0.5- to 20-year age range provided impedance- and electrocardiography recordings from which heart rate, different PNS-parameters (eg, respiratory sinus arrhythmia) and an SNS-parameter (pre-ejection period) were collected. Age trends were computed in the mean values across 12 age-bins and in the age-specific variances. Age was associated with changes in mean and variance of all parameters. PNS-activity followed a cubic trend, with an exponential increase from infancy, a plateau phase during middle childhood, followed by a decrease to adolescence. SNS-activity showed a more linear trend, with a gradual decrease from infancy to adolescence. Boys had higher SNS-activity at ages 11 to 15 years, while PNS-activity was higher at 5 and 11 to 12 years with the plateau level reached earlier in girls. Interindividual variation was high at all ages. Variance was reasonably stable for SNS- and the log-transformed PNS-parameters. Conclusions Cardiac PNS- and SNS-activity in childhood follows different maturational trajectories. Whereas PNS-activity shows a cubic trend with a plateau phase during middle childhood, SNS-activity shows a linear decrease from 0.5 to 20 years. Despite the large samples used, clinical use of the sex-specific centile and percentile normative values is modest in view of the large individual differences, even within narrow age bands.

Details

Original languageEnglish
Article numbere017405
JournalJournal of the American Heart Association
Volume10
Issue number4
Publication statusPublished - 2 Feb 2021
Peer-reviewedYes
Externally publishedYes

External IDs

PubMedCentral PMC7955328
Scopus 85101267358

Keywords

Keywords

  • Adolescent, Aging/physiology, Autonomic Nervous System/physiology, Child, Child, Preschool, Electrocardiography, Ambulatory/methods, Female, Follow-Up Studies, Heart Rate/physiology, Humans, Infant, Male, Young Adult

Library keywords