{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T16:49:49Z","timestamp":1791996589923,"version":"4.4.0"},"reference-count":70,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2021,2,16]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Despite the increasing interest in cardiac autonomic nervous activity, the normal development is not fully understood. The main aim was to determine the maturation of different cardiac sympathetic\u2010(SNS) and parasympathetic nervous system (PNS) activity parameters in healthy patients aged 0.5 to 20\u00a0years. A second aim was to determine potential sex differences.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">Five studies covering the 0.5\u2010 to 20\u2010year age range provided impedance\u2010 and electrocardiography recordings from which heart rate, different PNS\u2010parameters (eg, respiratory sinus arrhythmia) and an SNS\u2010parameter (pre\u2010ejection period) were collected. Age trends were computed in the mean values across 12 age\u2010bins and in the age\u2010specific variances. Age was associated with changes in mean and variance of all parameters. PNS\u2010activity followed a cubic trend, with an exponential increase from infancy, a plateau phase during middle childhood, followed by a decrease to adolescence. SNS\u2010activity showed a more linear trend, with a gradual decrease from infancy to adolescence. Boys had higher SNS\u2010activity at ages 11 to 15\u00a0years, while PNS\u2010activity was higher at 5 and 11 to 12\u00a0years with the plateau level reached earlier in girls. Interindividual variation was high at all ages. Variance was reasonably stable for SNS\u2010 and the log\u2010transformed PNS\u2010parameters.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Cardiac PNS\u2010 and SNS\u2010activity in childhood follows different maturational trajectories. Whereas PNS\u2010activity shows a cubic trend with a plateau phase during middle childhood, SNS\u2010activity shows a linear decrease from 0.5 to 20\u00a0years. Despite the large samples used, clinical use of the sex\u2010specific centile and percentile normative values is modest in view of the large individual differences, even within narrow age bands.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.120.017405","type":"journal-article","created":{"date-parts":[[2021,2,2]],"date-time":"2021-02-02T12:43:53Z","timestamp":1612269833000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":124,"title":["Maturation of the Cardiac Autonomic Nervous System Activity in Children and Adolescents"],"prefix":"10.1161","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1930-013X","authenticated-orcid":false,"given":"Lisette M.","family":"Harteveld","sequence":"first","affiliation":[{"name":"Department of Pediatric Cardiology Leiden University Medical Center Leiden The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1873-9922","authenticated-orcid":false,"given":"Ineke","family":"Nederend","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiology Leiden University Medical Center Leiden The Netherlands"},{"name":"Department of Biological Psychology Faculty of Human Behavioral and Movement Sciences Vrije Universiteit AmsterdamAmsterdam Public Health Research Institute Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3016-1086","authenticated-orcid":false,"given":"Arend D. 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