The state of response of autonomic nervous system in children with mitral valve prolapse

І.О.  Mitiuriaeva-Korniyko; O.V.  Kuleshov; Ya.A.  Medrazhevska; L.O.  Fik; T.D.  Klets

doi:10.26641/2307-0404.2021.4.248154

Авторы

І.О. Mitiuriaeva-Korniyko Bogomolets National Medical University, T. Shevchenko boul., 13, Kyiv, 01601, Ukraine https://orcid.org/0000-0002-6757-3415
O.V. Kuleshov National Pirogov Memorial Medical University, Pirogova str., 56, Vinnitsya, 21018, Ukraine https://orcid.org/0000-0003-0149-3452
Ya.A. Medrazhevska National Pirogov Memorial Medical University, Pirogova str., 56, Vinnitsya, 21018, Ukraine https://orcid.org/0000-0002-3736-8779
L.O. Fik National Pirogov Memorial Medical University, Pirogova str., 56, Vinnitsya, 21018, Ukraine https://orcid.org/0000-0002-8958-4844
T.D. Klets National Pirogov Memorial Medical University, Pirogova str., 56, Vinnitsya, 21018, Ukraine https://orcid.org/0000-0002-5556-9160

DOI:

https://doi.org/10.26641/2307-0404.2021.4.248154

Ключевые слова:

cardiointervalography, children, mitral valve prolapse, autonomic nervous system

Аннотация

The article presents summarized materials on connective tissue dysplasia of the heart, primary mitral valve prolapse, dysfunction of the autonomic system. Aim of research: to estimate the condition of autonomic nervous system in children with primary mitral valve prolapse. We examined 106 children with mitral valve prolapse aged from 13 to 17 years old on the clinical base of city hospital “Center of mother and child” in Vinnitsya. Research included time and frequency domain (evaluation with cardiointervalography. Final results were compared with the control group records. The results showed no statistical significance among time domain parameters in the main group of children. All these indices displayed tendency to sympathetic and parasympathetic autonomic nervous system tonus increase in boys. However, sympathicotonia tendency was noted in girls only. Frequency domain parameters showed similar results, compared with the previous. Nevertheless, very low frequency parameters had statistically significant difference in both subgroups of patience with mitral valve prolapse, including males (3205.8±190.9 against 1717±154, р<0.05) and females (3280±220.1 against 1433±811, р<0.05). There were no statistically significant difference among other frequency domain parameters. Conclusions: we estimated that children with mitral valve prolapse have imbalanced autonomic homeostasis manifested by tone disturbances of both autonomic vegetative system branches with sympathetic predominance. Patients with primary mitral valve prolapse generally have increased sympathetic tone - both boys and girls - according to spectral analysis of heart rate variability indices, heart rate oscillation power of a very low frequency in particular (p<0.05). In children with mitral valve prolapse, the tone of parasympathetic nervous system is generally normal; there is a tendency to its increase in boys and decrease in girls. These children should be under close medical supervision by pediatricians and cardiologists.

Библиографические ссылки

Ben Salha M. Ben, Repina NB. [Clinical diagnostics of undifferentiated connective tissue dysplasia]. Rossiyskiy mediko-biologicheskiy vestnik imeni akademika I.P. Pavlova. 2016;24(4):164-72. Russian. doi: https://doi.org/10.23888/PAVLOVJ20164164-172

Kalaeva GYu, Hohlova OI, Vasileva ND, Vlasova IV. [Features of the nervous system in adolescents with undifferentiated connective tissue dysplasia]. Mat i Ditya v Kuzbasse. 2013;1(52):13-17. Russian.

Kashitsina KA, Gorbacheva YuV. [Spectral characteristics of heart rhythm with different levels of physical activity]. Vestnik YuUrGU. 2012;28:124-5. Russian.

Kovaleva AV, Panova EN, Gorbacheva AK. [Analysis of heart rate variability and the possibility of its use in psychology and psychophysiology]. Sovremennaya zarubezhnaya psikhologiya. 2013;1:35-50. Russian.

Kuleshov OV. [Autonomic support in children with small cardiac abnormalities]. Vіsnyk Vіnnitskoho natsіonalnoho medychnoho unіversytetu. 2019;23(3):389-92.

doi: https://doi.org/10.31393/reports-vnmedical-2019-23(3)-08

Maidannyk VG, Mitiuriaieva-Korniiko IO, Kukhta NM, Hniloskurenko HV. [Vegetative dysfunction in children. Paroxysmal vegetative insufficiency]. Kyiv: Logos, 2017. p. 300. Ukrainian.

Nordhues BD, Siontis KC, Scott CG, et al. Bileaflet mitral valve prolapse and risk of ventricular dy¬srhythmias and death. Journal of Cardiovascular Electrophysiology. 2016,27(4):463-8. doi: https://doi.org/10.1111/jce.12914

Glantz SA. Primer of biostatistics. 7th ed. New York: McGraw-Hill; 2012. p. 327.

Narayanan K, Uy-Evanado A, Teodorescu C, et al. Mitral Valve Prolapse and Sudden Cardiac Arrest in the Community. Heart Rhythm. 2015,13(2):498-503. doi: https://doi.org/10.1016/j.hrthm.2015.09.026

Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. Heart rate variability. Standards of Measurement. Physiological interpretation and clinical use. Circulation. 1996,93:1043-65