Assessment of Cardiac Autonomic Regulation in Children with Monosymptomatic Nocturnal Enuresis by Analysis of Heart Rate Variability

Abstract

The pathogenesis of monosymptomatic nocturnal enuresis is controversial. Various urodynamic studies showed bladder hyperactivity in enuretic children. But the exact cause is not precisely known. The aim of this study was to understand whether the autonomic nervous system dysfunction is involved in this bladder hyperactivity or not. Heart rate variability measurement is widely used for evaluation of cardiac autonomic activity. We evaluated cardiac autonomic nervous system functions in monosymptomatic nocturnal enuretic children by using 24-hour Holter electrocardiogram. The study group consisted of 32 enuretic children (20 boys and 12 girls) and the control group consisted of 20 healthy children (12 boys and 8 girls). In these two growps, we assessed cardiac autonomic regulation by analysis of heart rate variability, and found a significantly higher parasympathetic activity in enuretic children than controls. We suggest that the parasympathetic nervous system hyperactivity plays a role in nocturnal enuresis by causing vesical hyperactivity in monosymptomatic enuretic children. monosymptomatic nocturnal enuresis; autonomic nervous regulation; heart rate variability; children

The Altered Autonomic Nervous System Activity in Iron Deficiency Anemia

“…Indeed, decrease in HRV was suggested to predict coronary heart disease morbidity and mortality in patients after an acute coronary event (Odemuyiwa et al 1991). Moreover, HRV parameters were found to be altered in various disorders such as diabetic neuropathy (Kitney et al 1982), heart failure (Saul et al 1988), acute leukemias (Nevruz et al 2007), allergic rhinitis , fetal type Minamata disease (Oka et al 2002), in preschool children with short nocturnal sleep (Sampei et al 2006), primary nocturnal enuresis (Dundaroz et al 2001;Unalacak et al 2004), following a cardiac transplantation (Sands et al 1989) or cardiac resynchronization therapy (Akyol et al 2006) and during adrenocorticotropic hormone replacement treatment in infants with West syndrome (Hattori et al 2007). Veglio et al (1998) reported decreased sympathetic activity in patients with thalassemia major.…”

Cardiac Autonomic Functions are Altered in Patients with Acute Leukemia, Assessed by Heart Rate Variability

“…Decrease in HRV has been found to predict coronary heart disease morbidity and mortality in apparently healthy populations and in patients after an acute coronary event (Akselrod et al 1981). There has been a large scale growth in HRV research in disease states such as diabetic neuropathy (Bernardi et al 1992), cardiac transplantation (Sands et al 1989), myocardial dysfunction (Casolo et al 1989), tetraplegia (Inoue et al 1990), preschool children with short nocturnal sleep (Sampei et al 2006), primary nocturnal enuresis (Dundaroz et al 2001;Unalacak et al 2004), allergic rhinitis (Yokusoglu et al 2007), fetal type Minamata disease (Oka et al 2003), administration of beta blockers (Adamson et al 1994), cardiac resynchronization therapy (Akyol et al 2006), antiarrhytmics (Zuanetti et al 1991) and scopolamine (De Ferrari et al 1993). However, the impact of HRV on clinical decisions is limited.…”

Cardiac Autonomic Hypofunction in Preschool Children with Short Nocturnal Sleep

“…Also, it has been suggested that subjects with low HRV had an adverse cardiovascular risk profile and an elevated risk of incident CHD and death (Dekker et al 2000), and that cardiovascular autonomic function played an important role in increasing blood pressure levels associated with increased modulation of parasympathetic tone of the heart after puberty but not in preadolescents (Tanaka et al 2000). In this way, HRV is thought to be a promising and reliable tool to provide a marker of less favorable health (Grandjean et al 2004;Unalacak et al 2004;Murata et al 2006), and this approach should be applied to sleep research in children.…”