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How to Predict the Impact of Methylphenidate on Cardiovascular Risk in Children with Attention Deficit Disorder: Methylphenidate Improves Autonomic Dysfunction in Children with ADHD

Background. Although stimulants have long been touted as treatments for attention deficit disorder with or without hyperactivity (ADHD), in recent years, increasing concerns have been raised about the cardiovascular safety of these medications. We aimed to prove if measurements of autonomic function...

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Autores principales: Buchhorn, Reiner, Müller, Christian, Willaschek, Christian, Norozi, Kambiz
Formato: Online Artículo Texto
Lenguaje:English
Publicado: International Scholarly Research Network 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3316982/
https://www.ncbi.nlm.nih.gov/pubmed/22530135
http://dx.doi.org/10.5402/2012/170935
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author Buchhorn, Reiner
Müller, Christian
Willaschek, Christian
Norozi, Kambiz
author_facet Buchhorn, Reiner
Müller, Christian
Willaschek, Christian
Norozi, Kambiz
author_sort Buchhorn, Reiner
collection PubMed
description Background. Although stimulants have long been touted as treatments for attention deficit disorder with or without hyperactivity (ADHD), in recent years, increasing concerns have been raised about the cardiovascular safety of these medications. We aimed to prove if measurements of autonomic function with time domain analysis of heart rate variability (HRV) in 24-hour Holter ECG are useful to predict the risk of sudden cardiac death in ADHD children and adolescents. Methods. We analysed HRV obtained from children with the diagnosis of ADHD prior to (N = 12) or during medical therapy (N = 19) with methylphenidate (MPH), aged 10.8 ± 2.0 years (mean ± SD), who were referred to our outpatient Paediatric Cardiology Clinic to rule out heart defect. As a control group, we compared the HRV data of 19 age-matched healthy children without heart defect. Results. Average HRV parameters from 24-hour ECG in the ADHD children prior to MPH showed significant lower values compared to healthy children with respect to rMSSD (26 ± 4 ms versus 44 ± 10 ms, P ≤ 0.0001) and pNN50 (6.5 ± 2.7% versus 21.5 ± 9.0%, P ≤ 0.0001). These values improved in MPH-treated children with ADHD (RMSSD: 36 ± 8 ms; pNN50: 14.2 ± 6.9%). Conclusion. Children who suffer from ADHD show significant changes in HRV that predominantly reflects diminished vagal tone, a well-known risk factor of sudden cardiac death in adults. In our pilot study, MPH treatment improved HRV.
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spelling pubmed-33169822012-04-23 How to Predict the Impact of Methylphenidate on Cardiovascular Risk in Children with Attention Deficit Disorder: Methylphenidate Improves Autonomic Dysfunction in Children with ADHD Buchhorn, Reiner Müller, Christian Willaschek, Christian Norozi, Kambiz ISRN Pharmacol Research Article Background. Although stimulants have long been touted as treatments for attention deficit disorder with or without hyperactivity (ADHD), in recent years, increasing concerns have been raised about the cardiovascular safety of these medications. We aimed to prove if measurements of autonomic function with time domain analysis of heart rate variability (HRV) in 24-hour Holter ECG are useful to predict the risk of sudden cardiac death in ADHD children and adolescents. Methods. We analysed HRV obtained from children with the diagnosis of ADHD prior to (N = 12) or during medical therapy (N = 19) with methylphenidate (MPH), aged 10.8 ± 2.0 years (mean ± SD), who were referred to our outpatient Paediatric Cardiology Clinic to rule out heart defect. As a control group, we compared the HRV data of 19 age-matched healthy children without heart defect. Results. Average HRV parameters from 24-hour ECG in the ADHD children prior to MPH showed significant lower values compared to healthy children with respect to rMSSD (26 ± 4 ms versus 44 ± 10 ms, P ≤ 0.0001) and pNN50 (6.5 ± 2.7% versus 21.5 ± 9.0%, P ≤ 0.0001). These values improved in MPH-treated children with ADHD (RMSSD: 36 ± 8 ms; pNN50: 14.2 ± 6.9%). Conclusion. Children who suffer from ADHD show significant changes in HRV that predominantly reflects diminished vagal tone, a well-known risk factor of sudden cardiac death in adults. In our pilot study, MPH treatment improved HRV. International Scholarly Research Network 2012-03-05 /pmc/articles/PMC3316982/ /pubmed/22530135 http://dx.doi.org/10.5402/2012/170935 Text en Copyright © 2012 Reiner Buchhorn et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Buchhorn, Reiner
Müller, Christian
Willaschek, Christian
Norozi, Kambiz
How to Predict the Impact of Methylphenidate on Cardiovascular Risk in Children with Attention Deficit Disorder: Methylphenidate Improves Autonomic Dysfunction in Children with ADHD
title How to Predict the Impact of Methylphenidate on Cardiovascular Risk in Children with Attention Deficit Disorder: Methylphenidate Improves Autonomic Dysfunction in Children with ADHD
title_full How to Predict the Impact of Methylphenidate on Cardiovascular Risk in Children with Attention Deficit Disorder: Methylphenidate Improves Autonomic Dysfunction in Children with ADHD
title_fullStr How to Predict the Impact of Methylphenidate on Cardiovascular Risk in Children with Attention Deficit Disorder: Methylphenidate Improves Autonomic Dysfunction in Children with ADHD
title_full_unstemmed How to Predict the Impact of Methylphenidate on Cardiovascular Risk in Children with Attention Deficit Disorder: Methylphenidate Improves Autonomic Dysfunction in Children with ADHD
title_short How to Predict the Impact of Methylphenidate on Cardiovascular Risk in Children with Attention Deficit Disorder: Methylphenidate Improves Autonomic Dysfunction in Children with ADHD
title_sort how to predict the impact of methylphenidate on cardiovascular risk in children with attention deficit disorder: methylphenidate improves autonomic dysfunction in children with adhd
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3316982/
https://www.ncbi.nlm.nih.gov/pubmed/22530135
http://dx.doi.org/10.5402/2012/170935
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