title: Improvement in sympatho-vagal imbalance and heart rate variability in patients with mitral stenosis after percutaneous balloon commissurotomy.
abstract: Elevated sympathetic nerve activity in patients with mitral stenosis (MS) may be an index of the severity of the disease. Percutaneous mitral balloon commissurotomy (PMBC) is now a standard treatment for many patients with symptomatic MS. We aimed to show the effects of PMBC on autonomic nervous system activity in the patients with MS by heart rate variability (HRV) analysis. Fifty-four consecutive patients with mitral stenosis and sinus rhythm who underwent percutaneous mitral commissurotomy were enrolled. Apart from significant haemodynamic improvements, mean heart rate (HR), LF day, LF night, LF/HF day and night significantly decreased and SDNN, RMSSD, PNN50, HF day and night significantly increased in the early period after PMBC and these changes were preserved for up to one month. SDNN was positively correlated with left ventricle ejection fraction (LVEF) but negatively correlated with mean valve area (MVA), left atrial (LA) diameter and pressure, right atrial (RA) pressure; LF/HF day ratio was positively correlated with LA diameter and pressure, mean transmitral gradient and negatively correlated with LVEF; LF/HF night ratio was positively correlated with LA pressure and mean transmitral gradient. The increase in SDNN was correlated with the change in LA and RA pressure. The decrease in LF/HF ratio after PMBC was significantly correlated with the changes in the mean transmitral gradient, LA pressure and RA pressure. As a result, the heart rate variability and autonomic nervous system function in patients with mitral stenosis are correlated with the atrial pressures and left ventricular function. These parameters significantly change in the early period after PMBC and are preserved at one month. The improvement in the heart rate variability and sympatho-vagal balance are significantly affected by the early changes in atrial pressures after PMBC.
authors.affiliation: Yüksek Ihtisas Hospital, Cardiology Clinics, Ilk yerlesim Mah. 338. Sokak Sayginlar Sitesi, No. C3/4 Batikent, 06370 Ankara, Turkey. drozdemir75@yahoo.com
authors.forename: Ozcan
authors.initials: O
authors.lastname: Ozdemir
authors.forename: Omer
authors.initials: O
authors.lastname: Alyan
authors.forename: Mustafa
authors.initials: M
authors.lastname: Soylu
authors.forename: Fatma
authors.initials: F
authors.lastname: Metin
authors.forename: Fehmi
authors.initials: F
authors.lastname: Kacmaz
authors.forename: Ahmet Duran
authors.initials: AD
authors.lastname: Demir
authors.forename: Bilal
authors.initials: B
authors.lastname: Geyik
authors.forename: Dursun
authors.initials: D
authors.lastname: Aras
authors.forename: Hatice
authors.initials: H
authors.lastname: Sasmaz
authors.forename: Sule
authors.initials: S
authors.lastname: Korkmaz
mesh_terms: D000328:Adult; D016279:Atrial Function, Left; D016280:Atrial Function, Right; D002404:Catheterization; D005260:Female; D006339:Heart Rate; D006801:Humans; D008297:Male; D008946:Mitral Valve Stenosis / Q000503:physiopathology* / Q000628:therapy*; D013564:Sympathetic Nervous System / Q000502:physiology*; D014630:Vagus Nerve / Q000502:physiology; D016277:Ventricular Function, Left