Effect of unconjugated hyperbilirubinemia on neonatal autonomic functions: evaluation by heart rate variability

Özdemir, Rahmi; Olukman, Özgür; Karadeniz, Cem; Çelik, Kıymet; Katipoğlu, Nagehan; Yılmazer, Murat Muhtar; Çalkavur, Şebnem; Meşe, Timur; Arslanoğlu, Sertaç

doi:10.1080/14767058.2017.1355901

Cited by 7 publications

(8 citation statements)

References 39 publications

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“…The LF/HF ratio is an indicator of sympathovagal balance. 17 The SDNN represents the overall HRV and the SDANN provides long-term information about HRV. The RMSSD and PNN50 values are used as an indicator of parasympathetic activity.…”

Section: Discussionmentioning

confidence: 99%

“…Increments of those two parameters represent a parasympathetic hyperactivity and loss of sympathetic activity. [17][18][19] It has been reported that low values of these parameters due to parasympathetic dysfunction precede increased inflammatory activity and raise cardiovascular mortality and morbidity. 20 Non-invasive cardiovascular reflex tests have been used in some studies to evaluate cardiovascular ANS in rheumatologic disorders.…”

Section: Discussionmentioning

confidence: 99%

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Heart rate variability in juvenile systemic lupus erythematosus patients

Başaran¹,

Çetin²,

Aydın³

et al. 2019

Turk J Pediatr

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Although neurological involvement has been well recognized in patients with systemic lupus erythematosus (SLE), autonomic nervous system (ANS) involvement has rarely been studied, and has shown conflicting results. The aim of this study was to evaluate the ANS functions by using heart rate variability (HRV) in juvenile patients with SLE. Sixteen juvenile-onset SLE patients and 16 healthy controls were enrolled in the study. All participants underwent 24-hour Holter electrocardiogram monitoring and HRV indices were assessed. The SLE disease activity index (SLEDAI) score was used to assess the disease activity. We analyzed the correlation between disease duration, the SLEDAI score, and the HRV domains. Overall HRV was diminished in patients with SLE compared to controls. There were negative correlations between day and night RMSSD (root-mean-square of the successive normal sinus NN interval differences) and PNN50 (percentage of successive normal sinus NN intervals >50 ms) values, and SLEDAI (r=-0.588 p=0.017; r=-0.607 p= 0.013; r=-0.498 p=0.049; r=-0.597 p=0.015, respectively). There were positive correlations between both day and night LF/HF values and SLEDAI (r=0.766 p=0.001; r=0.635 p=0.008, respectively). The results suggest that autonomic dysfunction exists in juvenile patients with SLE. As these children are at increased risk for cardiovascular disease, they need to be assessed for the development of autonomic dysfunction.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Heart rate variability in juvenile systemic lupus erythematosus patients

Başaran¹,

Çetin²,

Aydın³

et al. 2019

Turk J Pediatr

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“…Uhrikova et al (5) found that UCH caused heart rate variability by disrupting autonomic function. In another study performed with 50 cases with high bilirubin level (20.23±5.53 mg/dL) and 50 healthy newborns, Özdemir et al (8) found that the mean minimum heart rate, rMSDD, LF, and LF/HF ratio in the study group were significantly lower due to autonomic dysfunction caused by parasympathetic dominance. Bakrania et al (12) reported that in an in vitro study on hyperbilirubinemia, myocardial contractility was reduced, whereas in an in vivo study with mice, the ejection fraction and the shortening fraction were the same as in the control group.…”

Section: Discussionmentioning

confidence: 91%

“…Two in vitro studies performed on the effects of UCH on the myocardial tissue show that UCH damages it, and an in vivo study determines myocardial functional disorder that can be compensated (5,6) . A number of studies determine that bilirubin levels increase the tone of parasympathetic nervous system and cause heart rate variability (7,8) . To the best of our knowledge, there have been no reports on the high-level UCH effects over the ventricular functions on humans in vivo.…”

Section: Introductionmentioning

confidence: 99%

Effect of Neonatal Hyperbilirubinemia on Ventricular Functions

Karabulut¹,

Şimşek²

2019

ejcm

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Objectives: Unconjugated hyperbilirubinemia is a common systemic disease in neonates. Many studies on etiology, risk factors, and treatment have been conducted, and guidelines have been established. Because unconjugated hyperbilirubinemia is a systemic disease, it affects the body, cells, cellular organelles, organs, and systems. Studies have also attempted to clarify the levels, mechanisms, and organs affected by unconjugated bilirubin. We aimed to investigate the effect of high unconjugated bilirubin levels on the left and right ventricular systolic and diastolic functions in newborns by echocardiography and Doppler. Materials and Methods: This observational retrospectivecohort study evaluated neonates with hyperbilirubinemia requiring treatment according to the American Academy of Pediatrics guidelines, who were Results: There was no correlation between the serum total bilirubin levels and the echocardiographic measures.Conclusions: In our study, unconjugated hyperbilirubinemia did not affect the left and right ventricular functions.

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“…The alarm could activate when RMSSD decreases—lower modulation by vagal activity and, thus, risk of worse outcomes—but also when it rises significantly. For instance, an increase in RMSSD could represent pathological conditions, such as severe unconjugated hyperbilirubinemia (in association with low minimum HR) ( Özdemir et al, 2018 ), or the occurrence of an antenatal/intrapartum hypoxia–ischemia that could lead to brain injury ( Frasch, 2018 ; Yamaguchi et al, 2018 ).…”

Section: The Future Perspectives For the Clinical Use Of Hrv In The Nmentioning

confidence: 99%

Heart Rate Variability in the Perinatal Period: A Critical and Conceptual Review

Chiera¹,

Cerritelli²,

Casini³

et al. 2020

Front. Neurosci.

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Neonatal intensive care units (NICUs) greatly expand the use of technology. There is a need to accurately diagnose discomfort, pain, and complications, such as sepsis, mainly before they occur. While specific treatments are possible, they are often timeconsuming, invasive, or painful, with detrimental effects for the development of the infant. In the last 40 years, heart rate variability (HRV) has emerged as a noninvasive measurement to monitor newborns and infants, but it still is underused. Hence, the present paper aims to review the utility of HRV in neonatology and the instruments available to assess it, showing how HRV could be an innovative tool in the years to come. When continuously monitored, HRV could help assess the baby's overall wellbeing and neurological development to detect stress-/painrelated behaviors or pathological conditions, such as respiratory distress syndrome and hyperbilirubinemia, to address when to perform procedures to reduce the baby's stress/pain and interventions, such as therapeutic hypothermia, and to avoid severe complications, such as sepsis and necrotizing enterocolitis, thus reducing mortality. Based on literature and previous experiences, the first step to efficiently introduce HRV in the NICUs could consist in a monitoring system that uses photoplethysmography, which is low-cost and non-invasive, and displays one or a few metrics with good clinical utility. However, to fully harness HRV clinical potential and to greatly improve neonatal care, the monitoring systems will have to rely on modern bioinformatics (machine learning and artificial intelligence algorithms), which could easily integrate infant's HRV metrics, vital signs, and especially past history, thus elaborating models capable to efficiently monitor and predict the infant's clinical conditions. For this reason, hospitals and institutions will have to establish tight collaborations between the obstetric, neonatal, and pediatric departments: this way, healthcare would truly improve in every stage of the perinatal period (from conception to the first years of life), since information about patients' health would flow freely among different professionals, and high-quality research could be performed integrating the data recorded in those departments.

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Effect of unconjugated hyperbilirubinemia on neonatal autonomic functions: evaluation by heart rate variability

Abstract: Severe UHB may cause cardiac autonomic dysfunction in favor of parasympathetic predominance in jaundiced neonates.

Cited by 7 publications

References 39 publications

Heart rate variability in juvenile systemic lupus erythematosus patients

Heart rate variability in juvenile systemic lupus erythematosus patients

Effect of Neonatal Hyperbilirubinemia on Ventricular Functions

Heart Rate Variability in the Perinatal Period: A Critical and Conceptual Review

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