Cardiac autonomic function in adults born preterm
Karvonen, Risto; Sipola, Marika; Kiviniemi, Antti; Tikanmäki, Marjaana; Järvelin, Marjo-Riitta; Eriksson, Johan G.; Tulppo, Mikko; Vääräsmäki, Marja; Kajantie, Eero (2019-02-04)
Karvonen, R., Sipola, M., Kiviniemi, A., Tikanmäki, M., Järvelin, M.-R., Eriksson, J. G., … Kajantie, E. (2019). Cardiac Autonomic Function in Adults Born Preterm. The Journal of Pediatrics, 208, 96–103.e4. https://doi.org/10.1016/j.jpeds.2018.12.061
© 2019. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http:/creativecommons.org/licenses/by-nc-nd/4.0/
https://creativecommons.org/licenses/by-nc-nd/4.0/
https://urn.fi/URN:NBN:fi-fe2019051515693
Tiivistelmä
Abstract
Objective: To evaluate cardiac autonomic function in adults born preterm.
Study design: We studied the association between prematurity and cardiac autonomic function using heart rate variability measurements in 600 adults (mean age of 23.3 years) from a geographically based cohort in Northern Finland. There were 117 young adults born early preterm (<34 weeks), 207 born late preterm (34–36 weeks), and 276 born at term (≥37 weeks, controls). Autonomic function was analyzed by calculating time and frequency domain heart rate variability measurements using linear regression.
Results: Compared with controls, the mean difference in root mean square of successive differences (indicating cardiac vagal activity) was −12.0% (95% CI −22.2%, −0.5%, adjusted for sex, age, source cohort, and season P = .04) for the early preterm group and −7.8% (−16.8%, 2.0%, P = .12) for the late preterm group. Mean differences with controls in low frequency power (indicating cardiac vagal activity, including some sympathetic- and baroreflex-mediated effects) were −13.6% (−26.7%, 1.8%, P = .08) for the early preterm group and −16.4% (−27.0%, −4.3%, P = .01) for the late preterm group. Mean differences in high frequency power (quantifying cardiac vagal modulation in respiratory frequency) were −19.2% (−36.6%, 2.9%, P = .09) for the early preterm group and −13.8% (−29.4%, 5.3%, P = .15) for the late preterm group. Differences were attenuated when controlled for body mass index and physical activity.
Conclusions: Our results suggest altered autonomic regulatory control in adults born preterm, including those born late preterm. Altered autonomic regulatory control may contribute to increased cardiovascular risk in adults born preterm.
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