Identification of development and autonomic nerve activity from heart rate variability in preterm infants.

Heartbeat intervals, which are determined basically by regular excitations of the sinoatrial node, show significant fluctuation referred to as the heart rate variability (HRV). The HRV is mostly due to nerve activities through the sympathetic and parasympathetic branches of the autonomic nervous system (ANS). In recent years, it has been recognized that the HRV shows a greater complexity than ever expected, suggesting that it includes much information about ANS activities. In this study, we investigated relationship between HRV and development in preterm infants. To this end, heartbeat intervals were continuously recorded from 11 preterm infants in NICU. The recording periods were ranging from several days to weeks depending on the individuals. The HRV at various ages was then characterized by several indices. They include power spectrum as well as the mean and standard deviation of the series. For the power spectrum, the low-frequency band power (LF), high-frequency band power (HF), LF/HF (the ratio between LF and HF), beta (scaling exponent of the spectrum) were estimated. The detrended fluctuation analysis (DFA) was also employed to obtain short- and long-range scaling exponents. Each of these indices showed a correlation with the age. We showed that the long-range scaling exponent, derived from the DFA, was most significantly correlated with the age, suggesting that it could be a robust index to characterize the development of preterm infants.