Autonomic Disturbances in Children with Nutcracker Syndrome: A Case Control Study.

IF 1.7 4区医学 Q2 PEDIATRICS

Indian pediatrics Pub Date : 2024-12-15 Epub Date: 2024-09-10

Yasemin Nuran Dönmez, Adem Yasin Koksoy, Derya Bako, Dilek Giray, Serdar Epcacan

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引用次数: 0

Abstract

Objective: To describe the autonomic nervous system abnormalities including frequency of orthostatic symptoms, orthostatic response to the active standing test and analysis of heart rate variability (HRV) parameters in children with Nutcracker syndrome (NCS).

Methods: A case-control study was conducted between May and November 2023. We included children with NCS and healthy age- and sex-matched healthy controls. Children were evaluated for autonomic system disturbances by history for orthostatic symptoms, performance in an active standing test, 24-hour holter monitoring to determine the heart rate variability (HRV), maximum and minimum heart rates, and the average heart rate and urine analysis for orthostatic proteinuria and hematuria.

Results: 45 children with NCS and 47 age-matched healthy controls were included. Orthostatic symptoms were observed in 55.5% of the NCS patients, with dizziness being the predominant complaint (37%), followed by fatigue (20%), palpitations (13%), headache (11%), vision disturbances (11%), syncope (6%), chest discomfort (4%), and diaphoresis (2%). In the 24-h holter monitoring of 24 patients, a decrease in the standard deviation of the NN intervals (SDNN), root mean square of successive R-wave peak to R-wave peak (RR) interval differences (rMSSD) was observed. SDNN was significantly lower in NCS compared to the control group; 135.5 (42.3) vs 155.9 (35.2), P = 0.039. rMSDD was also significantly lower in the NCS compared to control group; 46.2 (19.7) vs 61.3 (26.6), P = 0.020. The mean (SD) maximum heart rate was higher in NCS compared to control group; 172.3 (28.4) vs 159.4 (14.6), P = 0.015.

Conclusion: Autonomic nervous system dysfunction and orthostatic disturbances may be seen in children with NCS.

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胡桃钳综合征患儿的自主神经紊乱：病例对照研究

目的描述胡桃钳综合征（NCS）患儿自律神经系统的异常情况，包括直立性症状的频率、对主动站立测试的直立性反应以及心率变异参数的损害：方法：2023 年 5 月至 11 月期间进行了一项病例对照研究。我们纳入了 NCS 儿童和年龄与性别匹配的健康对照组。通过以下方法评估儿童的自律神经系统紊乱情况：询问儿童是否有正位性症状、进行主动站立测试、进行 24 小时心电图监测以确定心率变异性 (HRV)、最大和最小心率以及平均心率，并进行尿液分析以确定是否有正位性蛋白尿和血尿：结果：共纳入 45 名非典型肺炎患儿和 47 名年龄匹配的健康对照组患儿。55.5%的 NCS 患者出现了直立性症状，其中以头晕为主诉（37%），其次是乏力（20%）、心悸（13%）、头痛（11%）、视力障碍（11%）、晕厥（6%）、胸部不适（4%）和心悸（2%）。在对 24 名患者进行的 24 小时心电图监测中，观察到 NN 间期标准差（SDNN）、连续 R 波峰值至 R 波峰值（RR）间期差的均方根（rMSSD）均有所下降。与对照组相比，NCS 组的 SDNN 明显降低；135.5 (42.3) vs 155.9 (35.2)，P = 0.039；与对照组相比，NCS 组的 rMSDD 也明显降低；46.2 (19.7) vs 61.3 (26.6)，P = 0.020。与对照组相比，NCS 组的平均（标清）最大心率更高；172.3 (28.4) vs 159.4 (14.6)，P = 0.015：结论：NCS 儿童可能会出现自主神经系统功能障碍和正张力紊乱。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Indian pediatrics 医学-小儿科

CiteScore

3.30

自引率

8.70%

发文量

344

审稿时长

3-8 weeks

期刊介绍： The general objective of Indian Pediatrics is "To promote the science and practice of Pediatrics." An important guiding principle has been the simultaneous need to inform, educate and entertain the target audience. The specific key objectives are: -To publish original, relevant, well researched peer reviewed articles on issues related to child health. -To provide continuing education to support informed clinical decisions and research. -To foster responsible and balanced debate on controversial issues that affect child health, including non-clinical areas such as medical education, ethics, law, environment and economics. -To achieve the highest level of ethical medical journalism and to produce a publication that is timely, credible and enjoyable to read.