Open AccessSympathetic Overactivity in Patients with Rheumatic Mitral Stenosis
Author(s) -
Ozdemir Ozcan,
Alyan Omer,
Soylu Mustafa,
Metin Fatma,
Demir Ahmet Duran,
Geyik Bilal,
Aras Dursun,
Özbakir Cemal,
Cihan Gökhan,
Sasmaz Hatice,
Korkmaz Sule
Publication year - 2004
Publication title -
annals of noninvasive electrocardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.494
H-Index - 48
eISSN - 1542-474X
pISSN - 1082-720X
DOI - 10.1111/j.1542-474x.2004.94575.x
Subject(s) - medicine , cardiology , stenosis , ventricle , ejection fraction , mitral valve , autonomic nervous system , mitral valve stenosis , heart rate variability , heart rate , heart failure , blood pressure
Background: Mitral stenosis may increase sympathetic nervous activity by increasing left atrial pressure and reducing cardiac output. And elevated sympathetic nerve activity may be a risk factor for the development of clinical manifestations of mitral stenosis. In this study, we assessed the autonomic nervous system activity in patients with mitral stenosis by heart rate variability analysis and defined factors affecting autonomic functions. Methods and Results: Fifty‐four patients with rheumatic mitral stenosis were compared with an age‐ and gender‐matched control group composed of 42 healthy individuals. SDNN, RMSSD, PNN50, and HF were lower; mean heart rate (HR), LF and LF/HF ratio were higher in the patients with mitral stenosis compared to the control group. SDNN was correlated positively with left ventricle ejection fraction (LVEF), negatively with mitral valve area, left atrial (LA) diameter, and duration of symptoms. RMSSD was correlated positively with mean transmitral gradient, negatively correlated with age; PNN50 was correlated negatively with mitral valve area and positively correlated with transmitral gradient. LF was positively and HF was negatively correlated with LA diameter; LF was correlated positively, and HF was negatively correlated with duration of symptoms. LF/HF ratio was positively correlated with LA diameter and duration of symptoms, negatively with LVEF and mean valve area. Conclusion: As a result, sympathetic nervous system activity is increased in patients with mitral stenosis and sympathetic overactivity worsens their symptoms. Most significant factors that affect autonomic functions in these patients are left atrial dilatation and mitral valve area.