Altered autonomic control of heart rate variability in the chronically hypoxic fetus
File(s)Shaw_et_al-2018-The_Journal_of_Physiology.pdf (1.69 MB)
Published version
Author(s)
Type
Journal Article
Abstract
Although fetal heart rate variability (FHRV) has long been recognised as a powerful predictor of fetal wellbeing, the mechanisms by which it is reduced in the chronically hypoxic fetus have yet to be established. In particular, the physiological mechanism underlying the reduction of short term variation (STV) in fetal compromise remains unclear. In this study, we present a longitudinal study of the development of autonomic control of FHRV, assessed by indirect indices, time domain (SDNN, RMSSD) and power spectral analysis (LF, HF, LF/HF), in normoxic and chronically hypoxic, chronically catheterised, singleton fetal sheep over the last third of gestation. We used isobaric chambers able to maintain pregnant sheep for prolonged periods in hypoxic conditions (stable fetal femoral arterial PO2 10-12 mmHg), and a customised wireless data acquisition system to record beat-to-beat variation in the fetal heart rate. We determined in vivo longitudinal changes in overall FHRV and the sympathetic and parasympathetic contribution to FHRV in hypoxic (n = 6) and normoxic (n = 6) ovine fetuses with advancing gestational age. Normoxic fetuses show gestational age-related increases in overall indices of FHRV, and in the sympathetic nervous system contribution to FHRV (P < 0.001). Conversely, gestational-age related increases in overall FHRV were impaired by exposure to chronic hypoxia, and there was evidence of suppression of the sympathetic nervous system control of FHRV after 72 h of exposure to hypoxia (P < 0.001). This demonstrates that exposure to late gestation isolated chronical fetal hypoxia has the potential to alter the development of the autonomic nervous system control of FHRV in sheep. This presents a potential mechanism by which a reduction in indices of FHRV in human fetuses affected by uteroplacental dysfunction can predict fetuses at increased risk. This article is protected by copyright. All rights reserved.
Date Issued
2018-12-01
Date Acceptance
2018-03-19
Citation
The Journal of Physiological, 2018, 596 (23), pp.6105-6119
ISSN
1469-7793
Publisher
The Physiological Society
Start Page
6105
End Page
6119
Journal / Book Title
The Journal of Physiological
Volume
596
Issue
23
Copyright Statement
© 2018 The Authors. The Journal of Physiology published by John Wiley & Sons Ltd on behalf of The Physiological Society
This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/29604064
Subjects
Science & Technology
Life Sciences & Biomedicine
Neurosciences
Physiology
Neurosciences & Neurology
Fetal heart rate
Fetal heart rate variability
Sympathetic nervous system
Fetal Growth Restriction
Intrauterine hypoxia
POWER SPECTRAL-ANALYSIS
BREATHING MOVEMENTS
ELECTROCORTICAL ACTIVITY
DOPPLER ULTRASOUND
RATE PATTERN
FETAL
HYPOXEMIA
ENDOCRINE
RESPONSES
STATES
Fetal Growth Restriction
Fetal heart rate
Fetal heart rate variability
Intrauterine hypoxia
Sympathetic nervous system
06 Biological Sciences
11 Medical and Health Sciences
Physiology
Publication Status
Published
Coverage Spatial
England
Date Publish Online
2018-03-31