Infants with univentricular heart have reduced heart rate and blood pressure responses to side motion and altered responses to head-up tilt

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    Abstract

    "Cardiovascular control was studied in infants with univentricular heart (UVH). Side motion tests and 45-s 45degrees head-up tilt tests were performed in 11 control and 9 UVH infants at the age of 13 +/- 3.2 wk. In addition, heart rate (HR) reactions to spontaneous arousals and HR variability during slow-wave sleep (SWS) were determined. All UVH infants had been hypoxic for several weeks, and during the sleep study the mean arterial oxyhemoglobin saturation was 82 +/- 5%. Tests were done at night during SWS, confirmed by polysomnographic recording. Continuous beat-to-beat blood pressure (BP) was measured. In the side-motion tests, control infants consistently showed a transient increase in HR and BP. This response was markedly reduced in all of the UVH infants (P < 0.0001). In tilt tests, the UVH infants showed normal BP responses, but, although a sustained 2.0% decrease in HR was observed in the controls, the UVH infants presented with a sustained 2.6% mean HR increase (P = 0.005). The UVH infants also showed attenuated HR acceleration during spontaneous arousals (P = 0.01), but HR variability did not differ significantly from the controls. In conclusion, UVH infants with chronic hypoxia exhibit defective vestibulosympathetic pathways, as expressed by an absence of acute HR and BP reactivity to side motion. HR reactions to postural challenge and spontaneous arousal are also altered. Autonomic function abnormalities in these infants are suggested to be secondary to hypoxia."
    Original languageEnglish
    JournalJournal of Applied Physiology
    Volume288
    Pages (from-to)518-525
    Number of pages8
    ISSN8750-7587
    DOIs
    Publication statusPublished - 2005
    MoE publication typeA1 Journal article-refereed

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