You are here

Home » Content

Mitral kapak prolapsuslu hastalarda kalp hızı değişkenliği ve sol ventrikül geometrisi arasındaki ilişki

Relationship between left ventricular geometry and heart rate variability in patients with mitral valve prolapsus

Journal Name:

  • Gülhane Tıp Dergisi

Publication Year:

  • 2005

Key Words:

Keywords (Original Language):

Author Name
Abstract (2. Language): 
Mitral valve prolapsus has an increased risk of arrhythmia. In this study, we aimed to examine if heart rate variability is different in patients with mitral prolapsus, and if it is, the relationship between the heart rate variability and eccentric hypertrophy. Forty eight subjects were divided into four groups according to the presence or absence of eccentric hypertrophy and mitral valve prolapsus: mitral valve prolapsus and left ventricular eccentric hypertrophy positive (Group 1, n=12, 25±4 years old, male to female ratio: 4/8), mitral valve prolapsus positive and left ventricular eccentric hypertrophy negative (Group 2, n=12, 23±5 years old, male to female ratio: 5/7), mitral valve prolapsus negative and left ventricular eccentric hypertrophy positive (Group 3, n=12, 26±7 years old, male to female ratio: 7/5), and mitral valve prolapsus and left ventricular eccentric hypertrophy negative (Group 4, n=12, 24±4 years old, male to female ratio: 7/5). The patients were asked to carry Holter electrocardiography device for 24 hours in order to measure the heart rate variability. Ventricular extrasystoles and automatically estimated heart rate variability parameters of time domain were compared among the groups. Age and sex were not different among the groups. Indexes, SDANN and rMSDD, were significantly lower in the patients with left ventricular eccentric hypertrophy (Groups 1 and 3) than in the patients without eccentric hypertrophy (Groups 2 and 4) (p<0.01). In contrast, the patients with mitral prolapsus (Groups 1 and 2) showed heart rate variability indexes that were not different significantly in relation to the patients without mitral valve prolapsus (Groups 3 and 4) (p>0.01). Ventricular extrasystoles were also higher in Group 1 patients (p<0.001). If there is no eccentric hypertrophy in patients with prolapsus, heart rate variability is normal. The eccentric hypertrophy is associated with decreased heart rate variability. These patients must be followed carefully with regard to arrhythmia.
Bookmark/Search this post with
Abstract (Original Language): 
Mitral kapak prolapsusu, aritmi riski ile beraber olan bir durumdur. Bu çalışmada mitral prolapsuslu hastalarda kalp hızı değişkenliğinde farklılık olup olmadığı, değişiklik varsa bunun sol ventrikül geometrisi ile ilişkisi araştırıldı. Çalışma grubunu oluşturan 48 birey mitral kapak prolapsusu ve sol ventrikül egzantrik hipertrofisi varlığına göre dört gruba ayrıldı: mitral kapak prolapsusu ve sol ventrikül egzantrik hipertrofisi olan (Grup 1, n=12, 25±4 yıl yaş, erkek/dişi oranı: 4/8); mitral kapak prolapsusu olan ancak sol ventrikül egzantrik hipertrofisi olmayan (Grup 2, n=12, 23±5 yıl yaş, erkek/dişi oranı: 5/7); mitral kapak prolapsusu olmayan ancak sol ventrikül egzantrik hipertrofisi olan (Grup 3, n=12, 26±7 yıl yaş, erkek/dişi oranı: 7/5); mitral kapak prolapsusu ve sol ventrikül egzantrik hipertrofisi olmayan (Grup 4, n=12, 24±4 yıl yaş, erkek/dişi oranı: 7/5). Kalp hızı değişkenliği için, 24 saat ambulatuvar EKG alındı. Ventriküler ekstrasistoller ve otomatik hesaplanan zamana dayalı kalp hızı değişkenliği karşılaştırıldı. Gruplarda yaş ve cinsiyet farklılığı yoktu. "Tüm normal RR intervallerinin standart sapması" ve "komşu RR intervalleri arasındaki farkın karelerinin ortalamasının karekökü", sol ventrikül egzantrik hipertrofili Grup 1 ve 3 hastalarda, egzantrik hipertrofi olmayan Grup 2 ve 4 hastalar ile karşılaştırıldığında anlamlı olarak daha düşüktü (p<0.01). Bu parametreler Grup 1 ve 3 ile Grup 2 ve 4 arasında benzerdi (p>0.01). Prolapsuslularda (Grup 1 ve 2), olmayanlara göre (Grup 3 ve 4) değişkenlik açısından fark yoktu (p>0.01). Ventriküler ekstrasistoller, Grup 1 hastalarda daha fazlaydı (p<0.001). Mitral prolapsusunda egzantik hipertrofi yoksa kalp hızı değişkenliği normal iken, egzantrik hipertofisi var ise azalmaktadır. Bu hastaların aritmi yönünden risk altında oldukları akılda tutulmalıdır.
FULL TEXT (PDF): 
PDF icon arastirmax-mitral-kapak-prolapsuslu-hastalarda-kalp-hizi-degiskenligi-sol-ventrikul-geometrisi-arasindaki-iliski.pdf
  • 4
260-264
  • Turkish

REFERENCES

References: 

1. Levy D, Savage DD. Prevalence and clinical
features of mitral valve prolapse. Am Heart
J 1987; 113: 1281-1290.
2. Devereux RB, Kramer-Fox R, Kligfield P.
Mitral valve prolapse: causes, clinical manifestations, and management. Ann Intern
Med 1989; 111: 305-317.
3. Deliagin VM, Pil'kh AD, Bazhenova LK.
Echocardiographic study of the heart in
children with mitral valve prolapse and
connective tissue dysplasia. Pediatriia 1990;
1: 52-58.
4. Vohra J, Sathe S, Warren R, Tatoulis J,
Hunt D. Malignant ventricular arrhythmias
in patients with mitral valve prolapse and
mild mitral regurgitation. Pacing Clin
Electrophysiol 1993; 16: 387-393.
5. Moritz HA, Parnass SM, Mitchell JS.
Ventricular fibrillation during anesthetic
induction in a child with undiagnosed
mitral valve prolapse. Anesth Analg 1997;
85: 59-61.
6. Terechtchenko L, Doronina SA, Pochinok
EM, Riftine A. Autonomic tone in patients
with supraventricular arrhythmia associated
with mitral valve prolapse in young men.
Pacing Clin Electrophysiol 2003; 26: 444-
446.
7. Katsanos KH, Pappas CJ, Patsouras D, et al.
Alarming atrioventricular block and mitral
valve prolapse in the Kearns-Sayre syndrome. Int J Cardiol 2002; 83: 179-181.
8. Gil R. Evaluation of the activity of the heart
conduction system with special reference to
the sinoatrial node automatism in patients
with mitral valve prolapse syndrome. Ann
Acad Med Stetin 1991; 37: 87-104.
9. Nedostup AV, Vein AM, Solov'eva AD, et
al. State of autonomic regulation in patients
with mitral valve prolapse and dysfunction
of sinus node. Klin Med (Mosk) 1996; 74:
35-39.
10. Mokaddem A, Sdiri W, Makni H, et al.
Mitral valve prolapse and sudden death: a
case report. Tunis Med 2002; 80: 349-351.
11. Fauchier JP, Babuty D, Fauchier L, et al.
Mitral valve prolapse, arrhythmias and sudden death. Arch Mal Coeur Vaiss 2000; 93:
1541-1547.
12. Shah AA, Quinones MA, Waggoner AD,
Barndt R, Miller RR. Pulsed doppler
echocardiographic detection of mitral
regurgitation in mitral valve prolapse: correlation with cardiac arrhythmias. Cathet
Cardiovasc Diagn 1982; 8: 437-444.
13. Babuty D, Cosnay P, Breuillac JC, et al.
Ventricular arrhythmia factors in mitral
valve prolapse. Pacing Clin Electrophysiol
1994; 17: 1090-1099.
14. Abildstrom SZ, Jensen BT, Agner E, et al;
BEAT Study Group. Heart rate versus
heart rate variability in risk prediction after
myocardial infarction. J Cardiovasc Electrophysiol 2003; 14: 168-173.
15. Sajadieh A, Rasmussen V, Hein HO,
Hansen JF. Familial predisposition to premature heart attack and reduced heart rate
variability. Am J Cardiol 2003; 92: 234-236.
16. Devereux RB, Pini R, Aurigemma GP,
Roman MJ. Measurement of left ventricular mass: methodology and expertise. J
Hypertens 1997; 15: 801-809.
17. Dabrowska B, Szpak W, Torbicki A.
Evaluation of 24-hour ambulatory ECG
recording in patients with mitral valve prolapse. Pol Arch Med Wewn 1990; 84: 344-
350.
18. Kochiadakis GE, Parthenakis FI, Zuridakis
EG, Rombola AT, Chrysostomakis SI,
Vardas PE. Is there increased sympathetic
activity in patients with mitral valve prolapse? Pacing Clin Electrophysiol. 1996; 19:
1872-1876.
19. Wojszwillo A, Loboz-Grudzien K, Jaroch J.
Signal averaged ECG in different patterns
of left ventricular hypertrophy and geometry in hypertension. Kardiol Pol 2003; 58:
335-343.264 · Aralýk 2005 · Gülhane TD Uzun ve ark.
20. Franchi F, Michelucci A, Padeletti L, et al.
Arrhythmogenicity in left ventricular
hypertrophy in mild to moderate arterial
hypertension. G Ital Cardiol 1992; 22: 905-
918.
21. Konradi AO, Zakharov DV, Rudomanov
OG, Iakovleva OI, Gerasimovich SA,
Shliakhto EV. Spectral analysis of the heart
rate variability in various types of the left
heart ventricle remodelling in patients with
hypertension. Westn Ross Akad Med Nauk
2001; 3: 27-31.
22. Pinho C, Dias DL, Figueiredo MJ, et al.
Correlation between ventricular arrhythmia and geometric remodeling of the left
ventricle in arterial hypertension. Arq Bras
Cardiol 1993; 61: 225-228.
23. Buda S, Stompor T, Sulowicz W, Kopec J,
Szymczakiewicz-Multanowska A, Janion
M. The impact of changes in levels of calcium, phosphate and magnesium during
hemodialysis on autonomic system reactivity as measured by heart rate variability
analysis. Przegl Lek 2000; 57: 340-345.

Thank you for copying data from http://www.arastirmax.com