Cardiac autonomic modulation in the supine and standing positions in nonobese, obese and morbidly obese children

Authors

  • Mário Augusto Paschoal Pontifícia Universidade Católica de Campinas
  • Mayra Caleffi Pereira Pontifícia Universidade Católica de Campinas

DOI:

https://doi.org/10.24220/2318-0897v19n1/6a827

Keywords:

Obesity, Autonomic functional test, Heart rate variability

Abstract

Objective
This study assessed the cardiac autonomic modulation in nonobese, obese and
morbidly obese children by cardiocirculatory stress induced by standing up from
the supine position.
Methods
This cross-sectional study included 30 children aged 9 to 11 years, divided into
three groups: a) nonobese (n=10), b) obese (n=10), c) morbidly obese (n=10),
based on their body mass indices, classified according to the National Center for
Health Statistics table. All of them underwent anthropometric and clinical
assessment, followed by active postural change from the supine heart rate were
monitored and the heart rate variability was analyzed.
Results
All groups presented a significant increase in sympathetic contribution and
decrease in parasympathetic activity when the heart rate in the supine and
standing positions were compared. The delta heart rate differed significantly (0
to 10s of active postural change) between the nonobese (+24.1bpm) and obese
groups (+21.7bpm).
Conclusion
Obesity did not affect the cardiovascular autonomic mechanisms significantly
when the heart rate variability from the supine to the standing position was
compared in nonobese, obese and morbidly obese children.

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Author Biographies

Mário Augusto Paschoal, Pontifícia Universidade Católica de Campinas

1 Pontifícia Universidade Católica de Campinas, Centro de Ciências da Vida, Faculdade de Fisioterapia. Av. Jonh Boyd Dunlop, s/n.,
Prédio Administrativo, Jd. Ipaussurama, 13090-950, Campinas, SP, Brasil. Correspondência para/Correspondence to: M.A. PASCHOAL.
E-mail: <fisioni@puc-campinas.edu.br>.

Mayra Caleffi Pereira, Pontifícia Universidade Católica de Campinas

1 Pontifícia Universidade Católica de Campinas, Centro de Ciências da Vida, Faculdade de Fisioterapia. Av. Jonh Boyd Dunlop, s/n.,
Prédio Administrativo, Jd. Ipaussurama, 13090-950, Campinas, SP, Brasil. 

References

Junqueira Jr, LF. Ambulatory assessment of cardiac autonomic function in Chagas’ heart disease patients based on indexes of R-R interval variation in the Valsalva maneuver. Brazilian J Med Biol Res. 1990; 23(11):1091-102.

La Rovere MT, Bigger JT, Marcus FI, Montana A, Schwart PJ. Baroreflex sensitivity and heart rate variability after myocardial infarction. ATRAMI (Autonomic Tone and Reflexes After Myocardial Infarction) Investigators. Lancet. 1998; 351(9101): 478-84.

Speiser PW, Rudolf MC, Anhalt H, Camacho-Hubner C, Chiarelli F, Eliakim A, et al. Childhood obesity. J Clin Endocrinol Metab. 2005; 90(3):1871-87.

Stunkard AJ, Wadden TA. Psychological aspects of human obesity. In: Björntorp P, Brodoff BN, editors. Obesity. Philadelphia: J.B. Lippincott Company; 1992. p.352-60.

Giuliano ICB, Caramelli B, Duncan BB, Pellanda LC. Children with adult hearts. Arq Bras Cardiol. 2009; 93(3):197-8.

Alonso DO, Forjaz CLM, Rezende LO, Braga AMFW, Barreto ACP, Negrão CE, et al. Comportamento da freqüência cardíaca e da sua variabilidade durante as diferentes fases do exercício progressivo Máximo. Arq Bras Cardiol. 1998; 71:787-92.

Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. Heart rate variability: standards of measurements, physiological interpretation and clinical use. Circulation. 1996; 93:1043-65.

Montano N. Heart rate variability as a clinical tool. ItaI Heart J. 2002; 3:439-45.

Martini G, Riva P, Rabbia F, Molini V, Ferrero GB, Cerutti F, et al. Heart rate variability in childhood obesity. Clin Auton Res. 2001; 11(2):87-91.

Faulkner MS, Hathaway D, Tolley B. Cardiovascularautonomic function in healthy adolescents. Heart Lung. 2003; 32(1):10-22.

Hainsworth R. Non-invasive investigation of cardiovascular reflexes in humans. Clin Sci. 1990; 78:437-43.

Narkiewicz K, Kato M, Pesek CA, Somers VK. Human obesity is characterized by a selective potentiation of central chemoreflex sensitivity. Hypertension. 1999; 33:1153-8.

National Center for Health Statistics. Pediatric growth charts provided by the CDC 2000. [cited 2007 Jan. 12]. Avaibable from: <http://www.cdc.gov/growthcharts/2000>.

Koch VH. Casual blood pressure and ambulatory blood pressure measurement in children. São Paulo Med J. 2003;121(2):85-9.

Porto CC. Exame clínico. 3ª ed. Rio de Janeiro: Guanabara Koogan; 1996. p.465.

Sant’Anna MSL, Tinoco ALA, Rosado LEFPL, Sant’Ana LFR, Mello AC, Brito ISS, et al. Avaliação de gordura corporal pela bioimpedância elétrica e sua correlação com diferentes pontos anatômicos de medida da circunferência da cintura em crianças. J Pediatr. 2009; 85(1)61-6.

McCarthy HD, Ellis SM, Cole TJ. Central overweight obesity in british youth aged 11-16year: cross sectional surveys of waist circunference. Br Med J. 2003; 326(7390):624.

Yusuf S, Hawken S, Ounpuu S, Bautista L, Franzosi MG, Commerford P, et al. and the INTERHEART Study Investigators. Obesity and the risk of myocardial infarction in 27,000 participants from 52 countries: a case-control study. Lancet. 2005; 366(9497):1640-9.

Must A, Jacques PF, Dallal GE, Bajema CJ, Dietz W. Long-term morbidity and mortality of overweight adolescents. A follow-up of the Harvard growth study of 1922 to 1935. N Engl J Med. 1992; 327(19): 1350-5.

Neto JE. Contribuição dos grandes vasos arteriais na adaptação cardiovascular a ortostase. Arq Bras Cardiol. 2006, 87(2):209-22.

Smitt AAJ, Halliwill JR, Low PA, Wieling W. Pathophysiological basis of orthostatic hypotension in autonomic failure. J Physiol. 1999; 519(1):1-10.

Lipsitz LA, Mietus J, Moody GB, Goldeberger AL. Spectral characteristics of heart rate variability before and during postural tilt: relations to aging and risk of syncope. Circulation. 1990; 81(6):1803-10.

Castro CLB, Nóbrega ACL, Araújo CGS. Testes autonômicos cardiovasculares. Uma revisão crítica. Parte I. Arq Bras Cardiol. 1992; 59(2):75-85.

Heinrich WL. Autonomic insufficiency. Arch Intern Med. 1982; 142(2):339-44.

Wieling W, Borst C, Karemaker JM, Dunning AJ. Testing for autonomic neuropathy: initial heart rate response to active and passive changes of posture. Clin Physiol. 1985; 5(Suppl 5):23-7.

Petrelluzzi KFS, Kawamura M, Paschoal MA. Avaliação funcional cardiovascular de crianças sedentárias obesas e não obesas. Rev Ciênc Méd. 2004; 13(2):127-36.

Rabbia F, Silke B, Conterno A. Assessment of cardiac autonomic modulation during adolescent obesity. Obes Res. 2003; 11(4):541-8.

Yakinci C, Mungen B, Karabiber H, Tayfun M, Evereklioglu C. Autonomic nervous system functions in obese children. Brain Dev. 2000; 22(3):151-3.

Laederach-Hofmann K, Mussgay L, Rúddel H. Autonomic cardiovascular regulation in obesity. J Endocrinol. 2000; 164:59-66.

Mancia G, Mark AL. Arterial baroreflexes in humans. In: Handbook of physiology, section 2: the cardiovascular system. Bethesda: American Physiological Society; 1983. p.755-813.

Ancona MC, Scodeler NF, Guidi RM, Paschoal MA. Variabilidade da freqüência cardíaca em crianças eutróficas e obesas nas posições supina e bípede. Rev Ciênc Méd. 2009; 18(2):69-79.

Published

2010-12-31

How to Cite

Paschoal, M. A., & Pereira, M. C. (2010). Cardiac autonomic modulation in the supine and standing positions in nonobese, obese and morbidly obese children. Revista De Ciências Médicas, 19(1/6), 33–41. https://doi.org/10.24220/2318-0897v19n1/6a827

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Artigos Originais