Mohammad S Alnoor1, Holly K Varner2, Ian J Butler3, Liang Zhu4, Mohammed T Numan5. 1. Department of Pediatrics, McGovern Medical School The University of Texas Health Science Center at Houston, Houston, TX, USA. alnoor.mohammad@gmail.com. 2. Department of Neurology, McGovern Medical School The University of Texas Health Science Center at Houston, Houston, TX, USA. 3. Division of Child and Adolescent Neurology, Department of Pediatrics, McGovern Medical School The University of Texas Health Science Center at Houston, Houston, TX, USA. 4. Division of Clinical and Translational Research, Department of Internal Medicine, McGovern Medical School The University of Texas Health Science Center at Houston, Houston, TX, USA. 5. Division of Pediatric Cardiology, Department of Pediatrics, McGovern Medical School The University of Texas Health Science Center at Houston, Houston, TX, USA.
Abstract
BACKGROUND: Baroreceptor function in children and adolescents has not been well studied in the current literature, with a lack of agreed upon normal values. The authors hypothesize that there is a significant increase in the baroreceptor activity with a decrease in the sensitivity during the upright phase in comparison to the supine phases of the head upright tilt test (HUTT) protocol. METHODS: Baroreceptor evaluation was performed using the sequence method in 49 subjects ages 8-21 years, during the 3 phases of HUTT: supine, head up, and post-tilt supine positions. Baroreceptor Effectiveness Index (BEI) and the number and slope of baroreceptor events were recorded. RESULTS: On study of the events and slope values, there was a significant difference between the three phases of the HUTT with regard to the baroreceptor activity and sensitivity. No significant difference was found in BEI. CONCLUSIONS: Our study presents normal values of baroreceptor activity, sensitivity, and BEI in pediatric patients under controlled supine and head up position. We also present new data regarding delayed heart rate responses to pressure changes in the Lag 1 and Lag 2 parameters, which may be beneficial in diagnosis and management of pediatric patients with orthostatic intolerance.
BACKGROUND: Baroreceptor function in children and adolescents has not been well studied in the current literature, with a lack of agreed upon normal values. The authors hypothesize that there is a significant increase in the baroreceptor activity with a decrease in the sensitivity during the upright phase in comparison to the supine phases of the head upright tilt test (HUTT) protocol. METHODS: Baroreceptor evaluation was performed using the sequence method in 49 subjects ages 8-21 years, during the 3 phases of HUTT: supine, head up, and post-tilt supine positions. Baroreceptor Effectiveness Index (BEI) and the number and slope of baroreceptor events were recorded. RESULTS: On study of the events and slope values, there was a significant difference between the three phases of the HUTT with regard to the baroreceptor activity and sensitivity. No significant difference was found in BEI. CONCLUSIONS: Our study presents normal values of baroreceptor activity, sensitivity, and BEI in pediatric patients under controlled supine and head up position. We also present new data regarding delayed heart rate responses to pressure changes in the Lag 1 and Lag 2 parameters, which may be beneficial in diagnosis and management of pediatric patients with orthostatic intolerance.
Authors: Mohammad S Alnoor; Holly K Varner; Ian J Butler; Jeremy E Lankford; Liang Zhu; Mohammed T Numan Journal: Pediatr Cardiol Date: 2022-01-28 Impact factor: 1.655