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24 Hour Heart Rate Variability Analysis (HRV) in Childhood - Prognostic Significance, Risk Factors & Clinical Applications (Hardcover)
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24 Hour Heart Rate Variability Analysis (HRV) in Childhood - Prognostic Significance, Risk Factors & Clinical Applications (Hardcover)
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Based upon the hypothesis that prognosis in childhood heart failure
depends on autonomic dysfunction, the author introduced a new heart
failure model and a medical therapy with beta-blockers in 1996. The
author used the analysis of heart rate variability (HRV) in 24
hours Holter ECG's for the understanding of the pathophysiology of
childhood heart failure and for objective control of medical
therapy. The success of this clinical model was the inspiration of
a new approach to mental disease in childhood. In the last decades,
an increase of new paediatric problems requiring medical care like
eating disorders, behavioural and attention problems has been
observed. All these diseases are related to autonomic dysfunction
and have a high impact on cardiovascular prognosis. Based upon the
hypothesis that behavioural problems are accompanied by changes in
the autonomic nervous system, the author performed analysis of HRV
in 24 hours Holter ECG's in these patient groups: healthy children
with respect to school affiliation; a historical control group from
literature published in 1997; attention deficit disorder with and
without hyperactivity; anorexia nervosa and obesity. This data was
compared to children with an increased cardiovascular risk due to
congenital heart disease. In order to analyse the effect of
autonomic function on human growth, we measured HRV in children
with growth failure. A new HRV Score was established for the
comparison of autonomic function in different age groups. The
author could demonstrate a decrease of vagal activity in healthy
children in children of today and speculate that insufficient vagal
maturation may be a reason for an increasing prevalence of mental
and cardiovascular disease. Looking for the reason of this vagal
shift, caloric over nutrition, omega-3-fatty acid deficiency, high
intensity of information and communication technology usage and
some environmental toxins reduce HRV in childhood.
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