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See detailPatterns of physical activity determined by heart rate monitoring among diabetic children
Massin, M. M.; LEBRETHON, Marie-Christine ULg; Brumioul, Danielle ULg et al

in Archives of Disease in Childhood (2005), 90(12), 1223-1226

Background: Children with type 1 diabetes should be encouraged to participate in physical activity because exercise can benefit insulin sensitivity and improve known risk factors for atherosclerosis ... [more ▼]

Background: Children with type 1 diabetes should be encouraged to participate in physical activity because exercise can benefit insulin sensitivity and improve known risk factors for atherosclerosis. Methods: Physical activity patterns of 127 children and adolescents with stable type 1 diabetes were investigated by 24 hour continuous heart rate monitoring. The percentage of heart rate reserve was used to measure the amounts of physical activity at different intensities. The results were compared with normative data. Results: Diabetic preschoolchildren accumulated 192.7 (78.1), 39.1 (24.3), and 21.3 (9.4) minutes/day (mean (SD)) of light, moderate, and vigorous physical activity, respectively. At the same activity levels, diabetic schoolchildren accumulated 168.9 (76.7), 37.9 (15.9), and 19.0 (14.8) minutes/day, and diabetic teenagers accumulated 166.3 (67.5), 45.6 (26.9), and 25.2 (15.3) minutes/day. Diabetic schoolchildren were significantly more active than healthy peers when considering moderate activity; diabetic teenagers were significantly more active when considering moderate and vigorous activity. There was a negative correlation between the most recent glycated haemoglobin and the time spent in light activities in schoolchildren, and a negative correlation between mean glycated haemoglobin for one year and time spent in light and moderate activities in schoolchildren. Conclusion: The majority of our diabetic patients meet the classical paediatric guidelines for physical activity and compare favourably with their healthy peers. [less ▲]

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See detailThe Influence of Fetal and Postnatal Growth on Heart Rate Variability in Young Infants
Massin, M. M.; Withofs, Nadia ULg; Maeyns, K. et al

in Cardiology (2001), 95(2), 80-3

Heart rate variability (HRV), a measure of cardiac autonomic control, was analyzed in infants to assess the hypothesis that early undernutrition may induce autonomic dysfunction that could play a role in ... [more ▼]

Heart rate variability (HRV), a measure of cardiac autonomic control, was analyzed in infants to assess the hypothesis that early undernutrition may induce autonomic dysfunction that could play a role in the programming of later cardiovascular disease. HRV data were collected during a night session in 546 healthy infants at 5-12 weeks of adjusted age, and statistical associations with fetal and postnatal growth indices were established. A significant positive correlation between birth weight, the ratio of neonatal weight to head circumference and postnatal weight gain, and HRV indices mostly influenced by sympathetic activity was demonstrated in 11- and 12-week-old infants. A slight correlation (p > 0.05) was also found in younger infants. These data suggest the influence of fetal and postnatal growth on the programming of the autonomic nervous system beyond the neonatal period. This influence may be one of the important mechanisms that link impaired growth in fetal and infant life to high blood pressure and other cardiovascular disease during childhood and adulthood (the Barker hypothesis). [less ▲]

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See detailCircadian Rhythm of Heart Rate and Heart Rate Variability
Massin, M. M.; Maeyns, K.; Withofs, Nadia ULg et al

in Archives of Disease in Childhood (2000), 83(2), 179-82

BACKGROUND: Measurements of heart rate variability (HRV) are increasingly used as markers of cardiac autonomic activity. AIM: To examine circadian variation in heart rate and HRV in children. SUBJECTS: A ... [more ▼]

BACKGROUND: Measurements of heart rate variability (HRV) are increasingly used as markers of cardiac autonomic activity. AIM: To examine circadian variation in heart rate and HRV in children. SUBJECTS: A total of 57 healthy infants and children, aged 2 months to 15 years, underwent ambulatory 24 hour Holter recording. Monitoring was also performed on five teenagers with diabetes mellitus and subclinical vagal neuropathy in order to identify the origin of the circadian variation in HRV. METHODS: The following variables were determined hourly: mean RR interval, four time domain (SDNN, SDNNi, rMSSD, and pNN50) and four frequency domain indices (very low, low and high frequency indices, low to high frequency ratio). A chronobiological analysis was made by cosinor method for each variable. RESULTS: A significant circadian variation in heart rate and HRV was present from late infancy or early childhood, characterised by a rise during sleep, except for the low to high frequency ratio that increased during daytime. The appearance of these circadian rhythms was associated with sleep maturation. Time of peak variability did not depend on age. Circadian variation was normal in patients with diabetes mellitus. CONCLUSION: We have identified a circadian rhythm of heart rate and HRV in infants and children. Our data confirm a progressive maturation of the autonomic nervous system and support the hypothesis that the organisation of sleep, associated with sympathetic withdrawal, is responsible for these rhythms. [less ▲]

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See detailDependency of Premature Ventricular Contractions on Heart Rate and Circadian Rhythms During Childhood
Massin, M. M.; Maeyns, K.; Withofs, Nadia ULg et al

in Cardiology (2000), 93(1-2), 70-3

The aim of the present study was to identify and quantify the rate dependence of premature ventricular contractions (PVC) during childhood. A 24-hour Holter recording was performed in 16 consecutive ... [more ▼]

The aim of the present study was to identify and quantify the rate dependence of premature ventricular contractions (PVC) during childhood. A 24-hour Holter recording was performed in 16 consecutive children, aged 22 days to 11 years (mean age 5.6 years), with frequent (>5,000/day), isolated monomorphic PVC. Those PVC were identified and the length of the preceding sinus cycle was measured. The values were ordered into 50-ms class intervals, and the percentage of PVC for each class was calculated and then analyzed by linear regression analysis. On the basis of the significance of the p value, and the positive or negative value of the slope, we identified a tachycardia-enhanced, a bradycardia-enhanced, and an indifferent pattern. Chronobiologic analysis was made by the cosinor method. All the patients had upper and lower limits of cycle length beyond which PVC disappeared. A tachycardia-enhanced pattern was present in 7 patients and an indifferent one in 9 patients. In the latter a second-degree polynomial correlation was systematically found. Children but not infants had a significant circadian variation in the frequency of PVC with a very variable time of highest incidence. In conclusion, it is possible to identify a circadian rhythm of PVC and a spontaneous trend between their incidence and the length of the preceding cardiac cycle in children. [less ▲]

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See detailCardiac autonomic dysfunction in diabetic children.
Massin, M. M.; Derkenne, B.; Tallsund, M. et al

in Diabetes care (1999), 22(11), 1845-50

OBJECTIVE: Adults with type 1 diabetes may have abnormal alterations in heart rate variability (HRV) due to cardiac autonomic neuropathy. This prospective study was performed to determine whether HRV can ... [more ▼]

OBJECTIVE: Adults with type 1 diabetes may have abnormal alterations in heart rate variability (HRV) due to cardiac autonomic neuropathy. This prospective study was performed to determine whether HRV can be used to detect subclinical autonomic neuropathy in diabetic children. RESEARCH DESIGN AND METHODS: We examined five time domain and three frequency domain HRV indices determined from 24-h Holter recordings in 73 diabetic children and adolescents aged 3-18 years (mean 12.1 years) with a mean duration of diabetes of 55 months. The measures were compared with normal ranges. Z scores were established for each parameter and were compared with classic risk factors of other diabetic complications. RESULTS: Most HRV indices were significantly depressed in children aged > or = 11 years, and the levels of HRV abnormalities were significantly correlated with long-term metabolic control (mean GHb for 4 years) in that age-group. In younger patients, HRV indices were within the normal range and were not correlated with the level of metabolic control. Illness duration and microalbuminuria but not short-term metabolic control (most recent GHb) were also independently predictive of HRV abnormalities. CONCLUSIONS: These results suggest that early puberty is a critical period for the development of diabetic cardiac autonomic dysfunction. Therefore, all type 1 diabetic patients should be screened for this complication by HRV analysis beginning at the first stage of puberty regardless of illness duration, microalbuminuria, and level of metabolic control. [less ▲]

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See detailGrowth of pulmonary artery after arterial switch operation for simple transposition of the great arteries.
Massin, M. M.; Nitsch, G. B.; Dabritz, S. et al

in European Journal of Pediatrics (1998), 157(2), 95-100

This retrospective study attempts to assess the size and growth pattern of the pulmonary artery about 1 year after neonatal arterial switch operation for simple transposition of the great arteries. Sixty ... [more ▼]

This retrospective study attempts to assess the size and growth pattern of the pulmonary artery about 1 year after neonatal arterial switch operation for simple transposition of the great arteries. Sixty-seven patients underwent cardiac catheterization, including catheterization of the right and left pulmonary arteries, and right ventricular angiography an average of 13.9 months after arterial switch operation. In 34 of these patients pre-operative right ventricular angiocardiograms were available. The diameter of the main pulmonary artery and that of its proximal right and left branches were measured. The values were compared to those of normal children matched for body surface area, taken from the literature and, for the branch values, related to the degree of branch stenosis and to the corresponding values, measured on pre-operative angiocardiograms. The cross-section of the main pulmonary artery after arterial switch operation with Lecompte manoeuvre becomes oval. The branches of the pulmonary artery are sometimes underdeveloped and this finding is related to branch stenosis. The ratio of the branch gradients is inversely proportional to the growth ratio of both branches while the pre- and postoperative Nakata indices are identical. CONCLUSION: The Lecompte manoeuvre induces a flattening of the main pulmonary artery with concomitant reduction of its cross-sectional area. There is also frequently trivial or rarely moderate branch pulmonary stenosis which is accompanied by growth retardation of the concerned branch. [less ▲]

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