Sympathetic overactivity in patients with rheumatic mitral stenosis.
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.


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.


CONCLUSIONS
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.
Türkiye Yüksek Ihtisas Hospital, Cardiology Clinics, Ankara, Turkey. drozdemir75@yahoo.com
Ozcan
O
Ozdemir
Omer
O
Alyan
Mustafa
M
Soylu
Fatma
F
Metin
Ahmet Duran
AD
Demir
Bilal
B
Geyik
Dursun
D
Aras
Cemal
C
Ozbakir
Gökhan
G
Cihan
Hatice
H
Sasmaz
Sule
S
Korkmaz
D000328:Adult; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D004452:Echocardiography; D015716:Electrocardiography, Ambulatory; D005260:Female; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D008297:Male; D008946:Mitral Valve Stenosis / Q000000981:diagnostic imaging / Q000503:physiopathology*; D011446:Prospective Studies; D012214:Rheumatic Heart Disease / Q000000981:diagnostic imaging / Q000503:physiopathology*; D013564:Sympathetic Nervous System / Q000503:physiopathology*