Abstract
Background: The study was conducted to investigate the implications of anthropometry in school-aged children on the degree of respiratory sinus arrhythmia observed in clinical settings. Methods: In a cohort study, 626 healthy children (52% male) aged 10.8 ± 0.5 years attending primary school in a single town underwent a 12-lead electrocardiogram coupled with measurements of height, weight and blood pressure. Indices of respiratory sinus arrhythmia (pvRSA, RMSSD, RMSSDc) were derived from semi-automatic measurements of RR intervals. Height, weight, BMI, blood pressure as well as waist and hip circumferences were compared between subjects with rhythmic heart rate and respiratory sinus arrhythmia, and correlations between indices of sinus arrhythmia and anthropometry were investigated. Results: Respiratory sinus arrhythmia was recognized in 43% of the participants. Subjects with sinus arrhythmia had lower heart rate (p < 0.001), weight (p = 0.009), BMI (p = 0.005) and systolic (p = 0.018) and diastolic (p = 0.004) blood pressure. There were important inverse correlations of heart rate and indices of sinus arrhythmia (r = −0.52 for pvRSA and r = −0.58 for RMSSD), but not the anthropometry. Conclusion: Lower prevalence of respiratory sinus arrhythmia among children with overweight and obesity is a result of higher resting heart rate observed in this population.
Highlights
Respiratory sinus arrhythmia is a physiological phenomenon, which can be recognized on an electrocardiogram (ECG) or during chest auscultation
The statistical analysis of anthropometry revealed no significant difference between boys and girls in age, height, weight or BMI
Waist circumference (p < 0.001) and systolic blood pressure (p = 0.037) were greater in boys as compared to girls, in contrast to heart rate (HR) that was significantly higher in girls (p < 0.001)
Summary
Respiratory sinus arrhythmia is a physiological phenomenon, which can be recognized on an electrocardiogram (ECG) or during chest auscultation. This automatic mechanism causes heart rate (HR) to increase during inspiration, enhancing effective gas exchange in the lungs, and to decrease during expiration, limiting energy expenditure on unnecessary heartbeats and preventing ineffective ventilation. In children and young adults, in whom the change of HR according to the respiratory phase is more pronounced, RSA can resemble heart rhythm disturbances; auscultation on breath-holding helps in differentiating RSA from other arrhythmias. The connection between RSA and parasympathetic activity is rarely used in clinical practice; the laboratory settings enable analysis of more complex patterns of heart rate variability (HRV). The study was conducted to investigate the implications of anthropometry in school-aged children on the degree of respiratory sinus arrhythmia observed in clinical settings
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