Heart rate variability indices in children with syncope due to orthostatic hypotension

  • Received 08.12.2021

  • Revised 21.02.2022

  • Accepted 29.03.2022



  • 778 Views

  • Retrieved from Vol. 4, No. 1, 2022

  • Pages 50-56

Summary. Orthostatic hypotension (OH) in children may be accompanied by symptoms such as dizziness and syncope and is often a manifestation of baroreflex failure due to autonomic imbalance. Heart rate variability (HRV) is one of the most effective methods of assessing the modulation of the autonomic nervous system and its balance. The aim of the study – to learn the features of autonomic nervous system modulation in children with syncope due to OH using HRV parameters. Materials and Methods. Twenty-five children aged 8–17 with a diagnosis of syncope due to OH and 41 practically healthy children were examined. The diagnostic criteria of the European Society of Cardiology (ESC 2018) were used to diagnose syncope due to OH. All patients were provided with accurate history taking, physical examination, active standing test, electrocardiography in 12 leads, echocardiography, electroencephalography and 24-hour Holter monitoring for HRV assessment. Results. There were no differences in values ​​of HRV parameters SDANN, RMSSD and pNN50 in children with syncope due to OH compared to healthy ones (p<0.05). These results generally indicate the normal activity of humoral influences and central oscillators against the background of balanced parasympathetic effects on the cardiovascular system in children with syncope. However, there were increased TP (10502.59±1526.62 ms2; 5482.44±396.87 ms2; p=0.0016), VLF (5768.27±774.29 ms2; 3906.29±269.09 ms2; p=0.046) and LF/HF ratio (1.75±0.18; 1.29 ± 0.09; p=0.044) in the group of syncope due to OH. Correlations were found between the number of syncope events and SDANN (r=-0.62; p=0.002), and RMSSD  (r=-0.46; p=0.03), duration of the last presyncope event and VLF (r=0.44; p =0.04), duration of the last syncope event and LF/HF ratio (r=0.57; p=0.006), 24-hour average interval PQ duration and SDANN (r=0.64; p=0.001), and RMSSD (r=0.63; p=0.002), 24-hour average interval QT duration and SDANN (r=0.43; p=0.04), and RMSSD (r=0.43; p=0.05) in patients with syncope due to OH. Conclusions. In children with syncope due to OH markers of pathological autonomic regulation are HRV parameters TP, VLF, and LF/HF ratio, and their increase values is evidence of predominance of the sympathetic circuit of heart rate regulation against the background of increased baroreflex activity of the heart and impaired adaptive-compensatory capabilities of the cardiovascular system including the activity of the central circuits of heart rate regulation

syncope due to orthostatic hypotension, heart rate variability, autonomic nervous system, children

https://doi.org/10.11603/bmbr.2706-6290.2022.1.12671

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