Abstract

Severe malnutrition can significantly compromise the autonomic nervous system. As there is limited information about the cardiac autonomic activity in severely acute malnourished children, our intention in this study is to assess the effect of severe malnutrition on heart rate variability (HRV), a noninvasive tool to estimate cardiac autonomic activity. The aim is to compare autonomic functions in severely acute malnourished children and controls aged 6 - 59 months by heart rate variability (HRV) analysis. Material and Methods: The study was conducted in the Department of Physiology, postgraduate laboratory, Gajra Raja Medical College, Gwalior. A total of 60 children were enrolled and divided into two groups: severe acute malnutrition (SAM group) and normally nourished children (control group) as per the Z-score criteria based on the nutritional status for height and age. The Control group was selected from patients who came into Out Patient Department (OPD). To analyze the HRV indices, the heart rate of each child in the supine position was recorded for 5 minutes. These indices were analyzed using linear methods in the time and frequency domains. Student's t-test for unpaired data was used to compare variables between groups with a significance level of 5%. Results: In severely acute malnourished children, a decrease in systolic and diastolic blood pressure and an increase in heart rate were found compared to normally nourished children. HRV indices indicate that malnourished children exhibit sympathetic and parasympathetic autonomic nervous system activity alteration. RR Interval, SDNN, RMSSD, LF (nu)%, and LF/HF indices were higher in SAM children. Conclusion: SAM children show changes in cardiac autonomic functions, characterized by modulation in sympathetic and parasympathetic activity, as well as increased heart rate and decreased blood pressure

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