[Functional evaluation of the autonomic regulation in mitral valve prolapse].
We examined fifty patients aged from 15 to 35 years, mean 23 +/- 5, with mitral valve prolapse (MVP) documented by two-dimensional echocardiography in the apical 4-chamber view as well as in the parasternal-long axis. The patients have been submitted to 4 tests: Valsalva maneuver, standing and exercise test and 24 hours ambulatory ECG monitoring. Fourty-five healthy subjects of similar age and sex served as controls. During the standing test the patients with MVP showed a significantly faster heart rate than the control subjects both in resting and in the standing position; during the exercise test they exhibited higher prevalence of ST segment and T wave abnormalities disappearing at the peak of the exercise. These observations support the hypothesis of a hyperadrenergic state. The greater bradycardia showed during the Valsalva maneuver, the lower heart rate and the higher incidence of bradyarrhythmias and A-V blocks during the sleeping period suggest an increased vagal tone. Our results suggest therefore that in subjects with MVP a dysfunction of both, sympathetic and parasympathetic nervous system is present.
D000293:Adolescent; D000328:Adult; D001145:Arrhythmias, Cardiac / Q000209:etiology; D001341:Autonomic Nervous System / Q000503:physiopathology*; D001794:Blood Pressure; D004452:Echocardiography; D004562:Electrocardiography; D005080:Exercise Test; D005260:Female; D006339:Heart Rate; D006801:Humans; D008297:Male; D008945:Mitral Valve Prolapse / Q000150:complications / Q000503:physiopathology*; D008991:Monitoring, Physiologic; D011187:Posture
Valutazione funzionale della regolazione neurovegetativa nel prolasso valvolare mitralico.