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Blood Pressure Variability and Baroreflex Sensitivity in Premature Newborns—An Effect of Postconceptional and Gestational Age

Introduction: Cardiovascular system is the vitally important system in the dynamical adaptation process of the newborns to the extrauterine environment. To reliably detect immaturity in the given organ system, it is crucial to study the development of the organ functions in relation to maturation pr...

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Autores principales: Javorka, Kamil, Haskova, Katarina, Czippelova, Barbora, Zibolen, Mirko, Javorka, Michal
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8281138/
https://www.ncbi.nlm.nih.gov/pubmed/34277515
http://dx.doi.org/10.3389/fped.2021.653573
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author Javorka, Kamil
Haskova, Katarina
Czippelova, Barbora
Zibolen, Mirko
Javorka, Michal
author_facet Javorka, Kamil
Haskova, Katarina
Czippelova, Barbora
Zibolen, Mirko
Javorka, Michal
author_sort Javorka, Kamil
collection PubMed
description Introduction: Cardiovascular system is the vitally important system in the dynamical adaptation process of the newborns to the extrauterine environment. To reliably detect immaturity in the given organ system, it is crucial to study the development of the organ functions in relation to maturation process. Objectives: The objective was to determine the changes in the spontaneous short-term blood pressure variability (BPV) and baroreflex sensitivity (BRS) reflecting various aspects of cardiovascular control during the process of maturation in preterm babies and to separate effects of gestational age and postnatal age. Methods: Thirty-three prematurely born infants without any signs of cardio-respiratory disorders (gestational age: 31.8, range: 27–36 weeks; birth weight: 1,704, range: 820–2,730 grams) were enrolled. Continuous peripheral blood pressure signal was obtained by non-invasive volume-clamp photoplethysmography method during supine rest. The recordings of 250 continuous beat-to-beat blood pressure values were processed by spectral analysis of BPV (assessed measures: total power, low frequency and high frequency powers of systolic BPV) and BRS calculation. For each infant we also assessed systolic, diastolic and mean blood pressures, heart rate and respiratory rate. Results: With the postconceptional age, BPV measures decreased (for total power: Spearman correlation coefficient r(s) = −0.345, P = 0.049; for low frequency power: r(s) = −0.365, P = 0.037; for high frequency power r(s) = −0.349; P = 0.046); and BRS increased significantly (r(s) = 0.448, P = 0.009). The further analysis demonstrated that these effects were more attributable to gestational age than to postnatal age. BRS correlated negatively with BPV magnitude (r(s) = −0.479 to −0.592, P = 0.001–0.005). Mean blood pressure and diastolic blood pressure increased during maturation (r(s) = 0.517 and 0.537, P = 0.002 and 0.001, respectively) while heart rate and respiratory rate decreased (r(s) = −0.366 and −0.516, P = 0.036 and 0.002, respectively). Conclusion: We conclude that maturation process is accompanied by an increased involvement of baroreflex buffering of spontaneous short-term blood pressure oscillations. Gestational age plays a dominant role not only in BPV changes but also in BRS, mean blood pressure, diastolic blood pressure and heart rate changes.
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spelling pubmed-82811382021-07-16 Blood Pressure Variability and Baroreflex Sensitivity in Premature Newborns—An Effect of Postconceptional and Gestational Age Javorka, Kamil Haskova, Katarina Czippelova, Barbora Zibolen, Mirko Javorka, Michal Front Pediatr Pediatrics Introduction: Cardiovascular system is the vitally important system in the dynamical adaptation process of the newborns to the extrauterine environment. To reliably detect immaturity in the given organ system, it is crucial to study the development of the organ functions in relation to maturation process. Objectives: The objective was to determine the changes in the spontaneous short-term blood pressure variability (BPV) and baroreflex sensitivity (BRS) reflecting various aspects of cardiovascular control during the process of maturation in preterm babies and to separate effects of gestational age and postnatal age. Methods: Thirty-three prematurely born infants without any signs of cardio-respiratory disorders (gestational age: 31.8, range: 27–36 weeks; birth weight: 1,704, range: 820–2,730 grams) were enrolled. Continuous peripheral blood pressure signal was obtained by non-invasive volume-clamp photoplethysmography method during supine rest. The recordings of 250 continuous beat-to-beat blood pressure values were processed by spectral analysis of BPV (assessed measures: total power, low frequency and high frequency powers of systolic BPV) and BRS calculation. For each infant we also assessed systolic, diastolic and mean blood pressures, heart rate and respiratory rate. Results: With the postconceptional age, BPV measures decreased (for total power: Spearman correlation coefficient r(s) = −0.345, P = 0.049; for low frequency power: r(s) = −0.365, P = 0.037; for high frequency power r(s) = −0.349; P = 0.046); and BRS increased significantly (r(s) = 0.448, P = 0.009). The further analysis demonstrated that these effects were more attributable to gestational age than to postnatal age. BRS correlated negatively with BPV magnitude (r(s) = −0.479 to −0.592, P = 0.001–0.005). Mean blood pressure and diastolic blood pressure increased during maturation (r(s) = 0.517 and 0.537, P = 0.002 and 0.001, respectively) while heart rate and respiratory rate decreased (r(s) = −0.366 and −0.516, P = 0.036 and 0.002, respectively). Conclusion: We conclude that maturation process is accompanied by an increased involvement of baroreflex buffering of spontaneous short-term blood pressure oscillations. Gestational age plays a dominant role not only in BPV changes but also in BRS, mean blood pressure, diastolic blood pressure and heart rate changes. Frontiers Media S.A. 2021-07-01 /pmc/articles/PMC8281138/ /pubmed/34277515 http://dx.doi.org/10.3389/fped.2021.653573 Text en Copyright © 2021 Javorka, Haskova, Czippelova, Zibolen and Javorka. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Pediatrics
Javorka, Kamil
Haskova, Katarina
Czippelova, Barbora
Zibolen, Mirko
Javorka, Michal
Blood Pressure Variability and Baroreflex Sensitivity in Premature Newborns—An Effect of Postconceptional and Gestational Age
title Blood Pressure Variability and Baroreflex Sensitivity in Premature Newborns—An Effect of Postconceptional and Gestational Age
title_full Blood Pressure Variability and Baroreflex Sensitivity in Premature Newborns—An Effect of Postconceptional and Gestational Age
title_fullStr Blood Pressure Variability and Baroreflex Sensitivity in Premature Newborns—An Effect of Postconceptional and Gestational Age
title_full_unstemmed Blood Pressure Variability and Baroreflex Sensitivity in Premature Newborns—An Effect of Postconceptional and Gestational Age
title_short Blood Pressure Variability and Baroreflex Sensitivity in Premature Newborns—An Effect of Postconceptional and Gestational Age
title_sort blood pressure variability and baroreflex sensitivity in premature newborns—an effect of postconceptional and gestational age
topic Pediatrics
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8281138/
https://www.ncbi.nlm.nih.gov/pubmed/34277515
http://dx.doi.org/10.3389/fped.2021.653573
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