TİP 1 DİABETES MELLİTUSLU ÇOCUK VE ADÖLESANLARDA KALP HIZI DEĞİŞKENLİĞİNİN DEĞERLENDİRİLMESİ

Öz

Amaç: Kalp hızı değişkenliği (KHD) kalbin nöral aktivitesini değerlendiren non invaziv bir indekstir. Diyabetli yetişkinlerde çeşitli kalp hızı değişkenliği anormallikleri tespit edilmiştir. Bununla birlikte diyabetli çocuklarda KHD konusunda az sayıda veri vardır.
Yöntem: Bu çalışmada 12 sağlıklı çocuk ve 18 diyabetli çocuğun pediyatrik kardiyoloji ünitesinde daha önceden var olan Holter monitorizasyon kayıtlarından KHD değerlendirildi. Çalışma ve kontrol grubunda 6 zaman bağımlı; (ortalama NN intervalleri, NN intervallerinin standart deviasyonu (SDNN), NN intervallerinin standart deviasyonlarının ortalaması (SDANN), SDNN indeksi, ardışık normal NN intervalleri arasındaki farkların karekökü (RMSSD), 50 milisaniyeyi aşan ardışık NN intervalleri arasındaki farkın yüzdesi (PNN50)) ve 3 frekans bağımlı; VLF (Very low frequency), LF (Low frequency) ve HF (High frequency), parametre değerlendirilerek KHD analizleri yapıldı.
Bulgular: Çalışmamızda çalışma grubunda RMSSD, SDNN indeksi ve SDSD parametrelerinde kontrol grubuna göre anlamlı farklılık bulundu. Ancak frekans bağımlı analizlerde anlamlı bir fark görülmedi.
Sonuç: Sonuç olarak asemptomatik diyabetik otonomik nöropatili çocuklarda KHD kardiyak otonomik nöropatiye işaret edebilir.

Anahtar Kelimeler

• Tip 1 diabetes mellitus,kalp hızı değişkenliği,diabetik otonomik nöropati

EVALUATION OF HEART RATE VARIABILITY IN CHILDREN AND ADOLECENTS WITH TYPE 1 DIABETES MELLITUS

Öz

Objective: Heart rate variability (HRV) is a noninvasive index of the neural activity of the heart. Although it is also influenced by the sympathetic activity of the heart, HRV is essentially determined by the vagal stimulation of the heart. Several HRV abnormalities have been described in adults with diabetes mellitus. However, there are few data on HRV in children with diabetes mellitus.
Methods: In this study, HRV was evaluated from preexisting Holter monitoring records in pediatric cardiology unit of 12 healthy children and 18 diabetic children. All had 12 channel electrocardiography and normal standard cardiac calculating six time-domain (mean N-N interval (NN), standard deviation of the N-N intervals (SDANN), SDNN indexes, RMSSD, PNN50), and three frequency-domain (low frequency [LF], high frequency [HF] and very low frequency (VLF) indexes. In the analysis of the diabetic and control population we found statistically differences in RMSSD, SDNN and SDSD parameters.
Results: In our study, significant differences were found in RMSSD, SDNN index and SDSD parameters in the study group compared to the control group. However, there was no significant difference in frequency dependent analysis.
Conclusion: Our results HRV can be interpreted as evidence of cardiac autonomic neuropathy in diabetic children with asymptomatic diabetic autonomic neuropathy.

Anahtar Kelimeler

• Type 1 diabetes mellitus,heart rate variability,diabetic autonomic neuropathy

Kaynakça

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