| Altered heart rhythm dynamics in very low birth weight infants with impending intraventricular hemorrhage. | |
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MedLine Citation:
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PMID: 19255007 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: Intraventricular hemorrhage remains an important problem among very low birth weight infants and may result in long-term neurodevelopmental disabilities. Neonatologists have been unable to accurately predict impending intraventricular hemorrhage. Because alterations in the autonomic nervous system's control of heart rhythm have been associated with intraventricular hemorrhage after its development, we sought to determine if early subtle alterations of heart rhythm could be predictive of impending intraventricular hemorrhage in very low birth weight infants. METHODS: This case-control study included 10 newborn very low birth weight infants with intraventricular hemorrhage (5 grade IV, 4 grade III, and 1 grade II) and 14 control infants without intraventricular hemorrhage. Heart rhythm data from the first day of life before the development of intraventricular hemorrhage were evaluated. Detrended fluctuation analysis, a nonlinear fractal heart rate variability method, was used to assess the fractal dynamics of the heart rhythm. Fractal scaling exponents were calculated by using this analysis. RESULTS: Twenty-four infants (mean +/- SD, birth weight: 845 +/- 213g: gestational age: 26.1 +/- 1.9 weeks) participated in the study. The short-term scaling exponent was significantly larger in infants who later developed intraventricular hemorrhage compared with those who did not (0.60 +/- 0.1 vs 0.45 +/- 0.1). A value of 0.52 resulted in 70% sensitivity and positive predictive value and 79% specificity and negative predictive value. The short-term scaling exponent was the only significant predictor of intraventricular hemorrhage. CONCLUSIONS: Fractal dynamics of the heart rhythm is significantly altered in very low birth weight infants before developing intraventricular hemorrhage and may be predictive of impending intraventricular hemorrhage. |
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Authors:
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Volkan Tuzcu; Selman Nas; Umit Ulusar; Ahmet Ugur; Jeffrey R Kaiser |
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Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural |
Journal Detail:
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Title: Pediatrics Volume: 123 ISSN: 1098-4275 ISO Abbreviation: Pediatrics Publication Date: 2009 Mar |
Date Detail:
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Created Date: 2009-03-03 Completed Date: 2009-03-30 Revised Date: 2012-03-28 |
Medline Journal Info:
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Nlm Unique ID: 0376422 Medline TA: Pediatrics Country: United States |
Other Details:
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Languages: eng Pagination: 810-5 Citation Subset: AIM; IM |
Affiliation:
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Arkansas Children's Hospital, Division of Cardiology, 1900 Maryland, Mail Slot 512-3, Little Rock, AR 72202, USA. tuzcuvolkan@uams.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Autonomic Nervous System
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physiopathology Case-Control Studies Cerebral Hemorrhage / diagnosis, physiopathology* Cerebral Ventricles Early Diagnosis Echoencephalography Electrocardiography Female Fractals Heart Rate / physiology* Humans Infant, Newborn Infant, Premature, Diseases / diagnosis, physiopathology* Infant, Very Low Birth Weight* Intensive Care Units, Neonatal Male Nonlinear Dynamics Predictive Value of Tests Probability ROC Curve Signal Processing, Computer-Assisted |
| Grant Support | |
ID/Acronym/Agency:
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1 K23 NS43185/NS/NINDS NIH HHS; K23 NS043185-05/NS/NINDS NIH HHS; M01RR14288/RR/NCRR NIH HHS; R01 NS060674-01A1/NS/NINDS NIH HHS; R01 NS060674-05/NS/NINDS NIH HHS; RR20146/RR/NCRR NIH HHS |
| Comments/Corrections | |
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