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Influence of prematurity and extrauterine development on the sleep state dependent heart rate patterns

Einfluss von Frühgeburtlichkeit und extrauteriner Entwicklung auf schlafstadienabhängige Herzfrequenzveränderungen

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Summary

Question of the Study

Premature birth and subsequent extrauterine development may lead to changes in brainstem functions. Central nervous cardiorespiratory regulation, especially the interaction between respiratory and cardiovascular systems, appears to be an essential component of brainstem maturation. The question arises whether premature birth and subsequent extrauterine development may influence sleep state dependent cardiorespiratory regulation.

Methods

We analysed sleep state dependent heart rate variability at high temporal resolution using Short Time Fourier Transform and heart rate changes accompanying sighs. The study was performed in premature infants reaching normal term and in full-term newborns.

Results

The mean R-R interval was shorter and heart rate variability was lower in all frequency bands (0.02–1 Hz) in premature infants reaching term in comparison with full-term newborns. This finding also applied to heart rate variability in the high frequency band (0.25–1 Hz) when different mean heart rates were taken into account. After sighs, heart rate acceleration could be observed in full-term newborns in active and quiet sleep, but did not appear in prematures reaching term. However, subsequent heart rate deceleration could be observed in both groups.

Conclusions

We suggest that premature birth and extrauterine development elicit different patterns of heart rate regulation, relative to full-term newborns.

Zusammenfassung

Fragestellung

Frühgeburtlichkeit und nachfolgende extrauterine Entwicklung können zu Veränderungen von Hirnstammfunktionen führen. Die zentralnervöse kardiorespiratorische Regulation und besonders die Interaktion zwischen Atmung und Herz-Kreislauf-System scheint ein wesentliches Moment der Hirnstammreifung zu sein. Es stellt sich die Frage, welchen Einfluss Frühgeburtlichkeit und nachfolgende extrauterine Entwicklung auf die verhaltensstadienabhängige kardiorespiratorische Regulation inklusive ihrer Hirnstammsteuerung hat.

Methodik

Wir untersuchten die Herzfrequenzvariabilität mittels der Spektralanalyse der RR-Intervall-Folge unter Nutzung der Short Time Fourier Transformation, die eine ausreichend hohe zeitliche Auflösung ermöglicht, und Herzfrequenzveränderungen bei Auftreten von Seufzern in Abhängigkeit vom aktuellen Verhaltenszustand. Die Untersuchungen wurden an Frühgeborenen zum Zeitpunkt des erwarteten Geburtstermins und an reifen Neugeborenen gleichen Konzeptionsalters vorgenommen.

Ergebnisse

Bei Frühgeborenen sind die RR-Intervalle im Mittel kürzer und die Herzfrequenzvariabilität aller untersuchten Frequenzbändern (0.02–1 Hz) niedriger im Vergleich zu reifen Neugeborenen. Das trifft auch für die Herzfrequenzvariabilität im hohen Frequenzband zu (0.25–1 Hz), wenn Unterschiede der mittleren Herzfrequenz berücksichtigt werden. Bei reifen Neugeborenen kann initial während Seufzern eine Herzfrequenzakzeleration sowohl im ruhigen als auch im aktiven Schlaf beobachtet werden, nicht jedoch bei Frühgeborenen zum erwarteten Termin. Eine nachfolgende Herzfrequenzdezeleration kann dagegen in beiden Gruppen nachgewiesen werden.

Schlussfolgerung

Wir vermuten, dass es bei Frühgeborenen und extrauteriner Entwicklung zu einer Veränderung der Herzfrequenzregulation im Vergleich zu reifen Neugeborenen kommt.

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Authors and Affiliations

  1. Institute of Medical Statistics, Computer Sciences and Documentation, Friedrich Schiller University, Jena, Germany

    H. Witte

  2. INSERM, Service de Physiologie, Hôpital Robert-Debré, Paris, France

    Lilia Curzi-Dascalova

  3. Institute of Pathophysiology, Friedrich Schiller University, 07740, Jena, Germany

    Michael Eiselt & Ulrich Zwiener

Authors
  1. Michael Eiselt
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  2. Ulrich Zwiener
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  3. H. Witte
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  4. Lilia Curzi-Dascalova
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Correspondence to Michael Eiselt.

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Eiselt, M., Zwiener, U., Witte, H. et al. Influence of prematurity and extrauterine development on the sleep state dependent heart rate patterns. Somnologie 6, 116–123 (2002). https://doi.org/10.1046/j.1439-054X.2002.02189.x

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