Arterial stiffness represents an independent predictor of the risk of subsequent cardiovascular events. Early identification of high-risk individuals is necessary for effective prevention and targeted interventions. Carotid wall echo-tracking is a modern method for an accurate evaluation of the structural and functional properties of carotid arteries. This study aimed to assess age and sex-specific reference values of the echo-tracking parameters of carotid stiffness in 400 healthy children and adolescents and to evaluate the potential early effect of elevated blood pressure and overweight in 69 overweight normotensives, 45 white coat hypertensives, and 44 essential hypertensives. Stiffness index β, pressure-strain elastic modulus (Ep), arterial compliance (AC), and pulse wave velocity β (PWV β) were evaluated using Aloka ProSound F75. Both white coat and essential hypertension were associated with impaired carotid wall properties with the greatest effect on Ep, followed by PWV β, index β, and AC. The excess weight showed a weaker effect on Ep and PWV β. This is the first study to compare the effects of white coat and essential hypertension on carotid arterial stiffness assessed using the echo-tracking technique in childhood and adolescence with direct application of pediatric reference values specific to age and sex.

• Publikační typ
• časopisecké články MeSH

Cardiovascular complications contribute to higher morbidity and mortality in patients with anorexia nervosa. We aimed to study biomarkers of cardiovascular risk in anorexic, normal-weight, and obese adolescents with focus on complex cardiovascular autonomic regulation and early arteriosclerotic damage. We examined 20 adolescent girls with anorexia nervosa, 20 obese girls, and 20 healthy normal-weight controls. Collected data: body composition analysis, 5 min recordings of R-R intervals and beat-to-beat blood pressure (BP), and arterial stiffness evaluated using cardio-ankle vascular index (CAVI). Evaluated parameters: beat-to-beat heart rate and BP variability, haemodynamic parameters (total peripheral resistance (TPR) cardiac output), CAVI, and anthropometric indices, including novel body roundness index (BRI). Adolescents with anorexia nervosa had increased CAVI associated with lower arterial constriction indexed by low-frequency band of BP variability compared with normal-weight peers (p = 0.03, p = 0.04, respectively) and obese adolescents (p < 0.01, p = 0.01, respectively). After normalization of CAVI and TPR by BRI, the relationship between CAVI and TPR was significant for all groups with the highest slope in the anorexia nervosa group (R2 = 0.724, p < 0.01). This is the first study revealing early arteriosclerotic damage in anorexic girls with increased CAVI. Complex analysis of cardiovascular autonomic regulation, and early arteriosclerotic, hemodynamic, and anthropometric changes in spectrum anorexia nervosa, normal weight, and obesity could help to understand the mechanisms of increased cardiovascular risk in malnutrition. Novelty Girls with anorexia nervosa showed signs of early arteriosclerotic damage indexed by CAVI. Insufficient sympathetic cardiovascular control was found already in adolescents with anorexia nervosa. The effect of body composition on CAVI was best predicted by novel body roundness index.

• MeSH
• dítě MeSH
• hemodynamika fyziologie   MeSH
• lidé MeSH
• mentální anorexie * epidemiologie   patofyziologie   MeSH
• mladiství MeSH
• obezita dětí a dospívajících * epidemiologie   patofyziologie   MeSH
• průřezové studie MeSH
• tuhost cévní stěny fyziologie   MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• mladiství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

Respiratory sinus arrhythmia (RSA), i.e. heart rate (HR) variations during inspiration and expiration, is considered as a noninvasive index of cardiac vagal control. Mitral valve prolapse (MVP) could be associated with increased cardiovascular risk; however, the studies are rare particularly at adolescent age. Therefore, we aimed to study cardiac vagal control indexed by RSA in adolescent patients suffering from MVP using short-term heart rate variability (HRV) analysis. We examined 12 adolescents (girls) with MVP (age 15.9±0.5 years) and 12 age and gender matched controls. Resting ECG was continuously recorded during 5 minutes. Evaluated HRV indices were RR interval (ms), rMSSD (ms), pNN50 (%), log HF (ms(2)), peak HF (Hz) and respiratory rate (breaths/min). RR interval was significantly shortened in MVP group compared to controls (p=0.004). HRV parameters-rMSSD, pNN50 and log HF were significantly lower in MVP compared to controls (p=0.017, p=0.014, p= 0.015 respectively). Our study revealed reduced RSA magnitude indicating impaired cardiac vagal control in MVP already at adolescent age that could be crucial for early diagnosis of cardiovascular risk in MVP.

• MeSH
• elektrokardiografie metody   MeSH
• index tělesné hmotnosti * MeSH
• lidé MeSH
• mladiství MeSH
• nervus vagus fyziologie   MeSH
• prolaps mitrální chlopně diagnóza   patofyziologie   MeSH
• respirační sinusová arytmie fyziologie   MeSH
• srdeční frekvence fyziologie   MeSH
• Check Tag
• lidé MeSH
• mladiství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

Respiratory sinus arrhythmia (RSA) is an index of cardiovagal regulation, emotional and cognitive processing. RSA is quantified using heart rate variability (HRV) spectral analysis at respiratory-linked high-frequency band (HF-HRV) using Fast Fourier transformation (FFT) or autoregressive (AR) method, both requiring resampling of recordings - a potential source of error. We hypothesized that rarely used HRV time-frequency analysis with Lomb-Scargle periodogram (LSP) without resampling could be more sensitive to detect neurocardiac response to posture change than FFT and AR. Orthostasis (posture change from supine to standing) evoked significant decrease of HF-HRV well detectable by FFT, AR, and LSP. In contrast, during posture change from sitting to lying, significant increase of HF-HRV and peak HF was best detected using LSP. In regression analysis, the associations between RR-interval, HF-HRV, and peak HF were best detected when evaluated using LSP. Time-frequency HRV analysis with LSP could represent an important alternative to conventional FFT and AR methods for assessment of cardiovagal regulation indexed by RSA.

• MeSH
• časové faktory MeSH
• dechová frekvence fyziologie   MeSH
• elektrokardiografie MeSH
• Fourierova analýza MeSH
• lidé MeSH
• mladiství MeSH
• neparametrická statistika MeSH
• regresní analýza MeSH
• respirační sinusová arytmie fyziologie   MeSH
• srdeční frekvence fyziologie   MeSH
• Check Tag
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

Arterial stiffness is a marker of vascular damage. Although adiposity increases cardiovascular risk, the relationship between paediatric overweight and arterial stiffness is unclear. The study aimed to evaluate the simultaneous effect of hypertension and overweight on arterial stiffness using cardio-ankle vascular index (CAVI) and related novel, theoretically blood pressure (BP)-independent, index CAVI0. CAVI and CAVI0 were measured in 140 adolescent boys (16.0 ± 1.9 years) divided into age-matched groups: normal-weight normotensives, overweight normotensives, overweight white-coat hypertensives, and overweight essential hypertensives. Overweight normotensives had significantly lower CAVI and CAVI0 compared to normal-weight normotensives (4.81 ± 0.64 vs. 5.33 ± 0.66, p < .01; 7.10 ± 0.99 vs. 7.81 ± 1.00, p < .01, respectively). CAVI and CAVI0 in overweight essential hypertensives showed no significant difference compared to normal-weight normotensives and were significantly higher compared to overweight normotensives (5.32 ± 0.77 vs. 4.81 ± 0.64, p < .01; 7.77 ± 1.19 vs. 7.10 ± 0.99, p < .01, respectively). CAVI, but not CAVI0, was associated positively with diastolic pressure (0.022 mmHg-1, p = .002) and negatively with pulse pressure (-0.022 mmHg-1, p = .001), and it was significantly higher in overweight white-coat hypertensives compared to overweight normotensives (5.20 ± 0.63 vs. 4.81 ± 0.64, p < .05). The lowering effect of overweight on arterial stiffness indexed by CAVI and CAVI0 in hypertensive adolescents seems to counterbalance the early arteriosclerotic effect of essential hypertension. The increase in CAVI, but not CAVI0, in overweight white-coat hypertensives could be attributable to residual BP dependence of CAVI, which is not present in CAVI0. Under certain conditions, CAVI0 may offer a clinically relevant improved assessment of arterial stiffness superior to CAVI.

• MeSH
• analýza pulzové vlny MeSH
• arterioskleróza diagnóza   MeSH
• hypertenze diagnóza   MeSH
• kotník krevní zásobení   MeSH
• krevní tlak MeSH
• lidé MeSH
• mladiství MeSH
• nadváha patologie   patofyziologie   MeSH
• rizikové faktory MeSH
• tuhost cévní stěny MeSH
• zlepšení kvality MeSH
• Check Tag
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

• MeSH
• nefrologie * dějiny   MeSH
• pediatrie * dějiny   MeSH
• Publikační typ
• biografie MeSH

• O autorovi
• Buchanec, Ján, 1936- Autorita

• Publikační typ
• abstrakt z konference MeSH

• Klíčová slova
• novorozenci, bolest procedurální, bolest-hodnocení, bolest - ovlivnění, N-PASS Neonatal Pain Agitation and Sedation Scale, NIPS Neonatal Infant Pain Scale,
• MeSH
• kojení MeSH
• neonatologie MeSH

Attention deficit/hyperactivity disorder (ADHD) is associated with complex neurocardiac integrity. We aimed to study heart rate time asymmetry as a nonlinear qualitative feature of heart rate variability indicating complexity of cardiac autonomic control at rest and in response to physiological stress (orthostasis) in children suffering from ADHD. Twenty boys with ADHD and 20 healthy age-matched boys at the age of 8 to 12 years were examined. The continuous ECG was recorded in a supine position and during postural change from lying to standing (orthostasis). Time irreversibility indices - Porta's (P%), Guzik's (G%) and Ehlers' (E) - were evaluated. Our analysis showed significantly reduced heart rate asymmetry indices at rest (P%: 49.8 % vs. 52.2 %; G%: 50.2 % vs. 53.2 %; p<0.02), and in response to orthostatic load (P%: 52.4 % vs. 54.5 %, G%: 52.3 % vs. 54.5 %; p<0.05) associated with tachycardia in ADHD children compared to controls. Concluding, our study firstly revealed the altered heart rate asymmetry pattern in children suffering from ADHD at rest as well as in response to posture change from lying to standing (orthostasis). These findings might reflect an abnormal complex cardiac regulatory system as a potential mechanism leading to later cardiac adverse outcomes in ADHD.

• MeSH
• dítě MeSH
• hyperkinetická porucha patofyziologie   MeSH
• lidé MeSH
• postura těla MeSH
• srdce patofyziologie   MeSH
• srdeční frekvence * MeSH
• studie případů a kontrol MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

Úvod: Variabilita frekvencie srdca – oscilácie frekvencie srdca okolo priemernej hodnoty – sú výsledkom interakcie regulaèných vplyvov autonómneho nervového systému, predovšetkým vagovej aktivity, na činnosť sinoatriálneho uzla. Dynamická rovnováha sympatikového/parasympatikového nervového systému je známkou adaptability a flexibili- ty „zdravého“ fyziologického systému. Predpokladá sa, že narušenie tej- to rovnováhy patrí medzi najvýznamnejšie patofyziologické mechaniz- my vedúce ku zvýšenému riziku kardiovaskulárnych ochorení, a preto sledovanie tzv. „kardiálneho rizika“ je veľmi dôležité práve pri psychic- kých poruchách. Metodika: Analýza zmien frekvencie srdca „od úderu k úderu“ použitím konvenèných- lineárnych (časová a spektrálna analýza) a nových ne- lineárnych metód (symbolická dynamika, časo vá ireverz ibilita) umožòuje odhaliť latentné a klinicky asymptomatické príznaky dysregulácie èinnosti srdca, čo predstavuje významný prínos nielen z hľadiska diagnostického, ale i terapeutického. Osobitnou otázkou je detský a adolescentný vek ako kri- tické a vulnerabilné vývojo vé obdobie pr e možnosť výskytu prvých diskrét- nych príznakov zmenenej regulácie chronotropnej èinnosti srdca. Z tohto h¾adiska sme sa zamerali na sledovanie možnej zmeny kardiálnej vagovej regulácie pri psychických poruchách (depresívna porucha, ADHD) práve v tomto vekovom období, a to použitím komplexného prístupu lineárnej a nelineárnej analýzy variability frekvencie srdca. Výsledky: Pri obidvoch psychických poruchách parametre lineárnej a nelineárnej analýzy VFS odhalili zníženú veľkosť , ako aj zmenu kom- plexity variability frekvencie srdca v pokoji, ako aj v odpovedi na stres (ortostatický test). Nelineárna analýza variability frekvencie srdca sa zda- la byť senzitívnejšou na zisť ovanie diskrétnych zmien kardiálnej regulá- cie v odpovedi na stres. Záver: Predpokladáme, že zmeny komplexnej neurokardiálnej regu- lácie pri psychických poruchách sú prítomné už v detskom a adolescent- nom veku. Hodnotenie variability frekvencie srdca tak môže poskytnúť dôležité informácie z hľadiska diagnostického, ako aj pri sledovaní tera- peutických intervencií.

Introduction: The interplay of sympathetic and parasympathetic outputs of the central autonomic network through sinoatrial node pro- duces the complex beat-to-beat oscillations in the heart rate around its mean value - heart rate variability (HRV). The dynamic sympathovagal balance repres ents the adaptability and flexibility of the healthy physio- logical syste m. It is supposed that autonomic imbalance could represent the important pathophysiological mechanism contributing to the higher risk of cardiovascular morbidity. Therefore, the assessment of the so-cal- led „cardiac risk“ is crucial especially in mental disorders. Methods: The analysis of the heart rate „beat-to-beat“ oscillations using traditional-linear methods (time and spectral analysis), and novel nonlinear approach (symbolic dynamics, time irreversibility) might de- tect clinically latent and asymptomatic signs of cardiac vagal regulati- on. Importantly, the childhood and adolescence could be a critical and vulnerable age period to a potential depression-induced cardiac autono- mic dysregulation due to developmental and brain maturational chan- ges. This question is still unanswered. From this point of view, we focu- sed on the evaluation of cardiac autonomic control in mental disorders (depressive disorder, ADHD) already in adolescent age. Results: We have found decreased magnitude and altered comple- xity of the heart rate variability at rest as well as in response to stress in both mental disorders. It seems that the HRV nonlinear analysis is more sensitive to detect discrete alteration in the neurocardiac regulation in response to stress (orthostatic test). Conclusion: These findings revealed discrete abnormalities of the car- diac autonomic regulation in mental disorders already in adolescent age. Thus, the HRV noninvasive complex analysis could provide important in- formation concerning diagnostic and therapeutic various points of view.

• Publikační typ
• abstrakt z konference MeSH