Tatiana Dias de Carvalho1, Thais Massetti2, Talita Dias da Silva3, Tânia Brusque Crocetta4, Regiani Guarnieri4, Luiz Carlos Marques Vanderlei5, Carlos Bandeira de Mello Monteiro2, David M Garner6, Celso Ferreira3. 1. Universidade Federal de São Paulo (UNIFESP), Departamento de Medicina, Disciplina de Cardiologia, São Paulo, SP, Brazil; Universidad Nacional de La Matanza (UNLaM), Departamento de Ciencias de la Salud, Kinesiología y Fisiatría, San Justo, BA, Argentina. Electronic address: carvalho.td1@gmail.com. 2. Universidade de São Paulo (USP), Faculdade de Medicina, Programa de Pós-graduação Ciências da Reabilitação, São Paulo, SP, Brazil. 3. Universidade Federal de São Paulo (UNIFESP), Departamento de Medicina, Disciplina de Cardiologia, São Paulo, SP, Brazil. 4. Faculdade de Medicina do ABC (FMABC), Laboratório de Escrita Científica, Santo André, SP, Brazil. 5. Universidade Estadual Paulista (UNESP), Departamento de Fisioterapia da Faculdade de Ciências e Tecnologia, Presidente Prudente, SP, Brazil. 6. Cardiorespiratory Research Group, Department of Biological and Medical Sciences, Oxford Brookes University, Headington Campus, Gipsy Lane, Oxford OX3 0BP, United Kingdom.
Abstract
INTRODUCTION: Down syndrome (DS) results in many changes, including dysfunction in cardiac autonomic modulation. Heart rate variability (HRV) analysis evaluates the autonomic function and it is a predictor of adverse cardiovascular events. OBJECTIVE: To present results of a systematic review and a meta-analysis about heart rate variability in individuals with DS. METHOD: A systematic review was performed on PubMed, PubMed Central and Web of science databases. We included articles that exhibited all the terms: "Down Syndrome", "heart rate variability", "autonomic nervous system", "autonomic dysfunction" and "cardiac autonomic modulation". We conducted the meta-analysis to compare "DS" to "controls" during rest. Random effects models were used, as were appropriate tests for heterogeneity. RESULTS: From 271 studies, 13 were included in our review. These are conducted with volunteers from a wide age range, of either gender, and not taking medications. Meta-analysis displayed that there were no significant differences between the groups at rest, except the RMSSD, which revealed a significant (Z = -2.80, p = 0.005) main effect (Hedge's g = -0.55, 95% CI [-0.93; -0.16]), indicating difference in individuals with DS compared with controls. CONCLUSION: There is autonomic dysfunction in individuals with DS, which may or may not be expressed at rest, but it is usually demonstrated in an autonomic task. Meta-analysis specified that there was no significant alteration between DS and the controls during rest, except RMSSD index which was lower in DS than controls. PROSPERO: CRD42017068647.
INTRODUCTION: Down syndrome (DS) results in many changes, including dysfunction in cardiac autonomic modulation. Heart rate variability (HRV) analysis evaluates the autonomic function and it is a predictor of adverse cardiovascular events. OBJECTIVE: To present results of a systematic review and a meta-analysis about heart rate variability in individuals with DS. METHOD: A systematic review was performed on PubMed, PubMed Central and Web of science databases. We included articles that exhibited all the terms: "Down Syndrome", "heart rate variability", "autonomic nervous system", "autonomic dysfunction" and "cardiac autonomic modulation". We conducted the meta-analysis to compare "DS" to "controls" during rest. Random effects models were used, as were appropriate tests for heterogeneity. RESULTS: From 271 studies, 13 were included in our review. These are conducted with volunteers from a wide age range, of either gender, and not taking medications. Meta-analysis displayed that there were no significant differences between the groups at rest, except the RMSSD, which revealed a significant (Z = -2.80, p = 0.005) main effect (Hedge's g = -0.55, 95% CI [-0.93; -0.16]), indicating difference in individuals with DS compared with controls. CONCLUSION: There is autonomic dysfunction in individuals with DS, which may or may not be expressed at rest, but it is usually demonstrated in an autonomic task. Meta-analysis specified that there was no significant alteration between DS and the controls during rest, except RMSSD index which was lower in DS than controls. PROSPERO: CRD42017068647.
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