Effect of metoprolol on heart rate variability in symptomatic patients with mitral valve prolapse.
Metoprolol is widely used to eliminate symptoms in patients with mitral valve prolapse (MVP), a condition associated with enhanced sympathetic tone. In this study, effects of metoprolol on heart rate variability (HRV) indices were investigated in symptomatic patients with MVP. Thirty-nine symptomatic patients with MVP (26 women, mean age 26 +/- 7 years) and 16 age- and gender-matched controls were studied. After a baseline 24-hour Holter evaluation in all subjects, patients with MVP were started on metoprolol succinate therapy at a dose of 25 to 100 mg/d, and Holter analysis was repeated at the end of 3 months of metoprolol therapy. At the basal evaluation, all time-domain HRV indices with the exception of proportion of adjacent RR intervals differing by >50 ms in the 24-hour recording were significantly lower in patients with MVP than controls (SD of all normal-to-normal [NN] intervals, p = 0.013; SD of average NN intervals calculated during 5-minute periods of the entire recording, p = 0.03; triangular index, p = 0.025; and square root of mean squared differences in successive NN intervals, p = 0.026). After metoprolol treatment, all HRV indices significantly improved compared with baseline (SD of all NN intervals, p = 0.028; SD of average NN intervals calculated during 5-minute periods of the entire recording, p = 0.043; triangular index, p = 0.004; square root of the mean squared differences in successive NN intervals, p = 0.021; and proportion of adjacent RR intervals differing by >50 ms in the 24-hour recording, p = 0.014), and HRV indices after metoprolol treatment were similar to those of the control group (p >0.05). In conclusion, metoprolol significantly improved impaired HRV parameters in symptomatic patients with MVP.
Taçoy
Gülten
G
Department of Cardiology, Gazi University School of Medicine, Ankara, Turkey. gtacoy@gmail.com
Balcioğlu
Akif Serhat
AS
Arslan
Uğur
U
Durakoğlugil
Emre
E
Erdem
Güliz
G
Ozdemir
Murat
M
Cengel
Atiye
A
D000293:Adolescent; D000319:Adrenergic beta-Antagonists / Q000494:pharmacology*; D000328:Adult; D000889:Anti-Arrhythmia Agents / Q000494:pharmacology; D016022:Case-Control Studies; D015716:Electrocardiography, Ambulatory; D005260:Female; D006339:Heart Rate / Q000187:drug effects*; D006801:Humans; D008297:Male; D008790:Metoprolol / Q000031:analogs & derivatives* / Q000494:pharmacology; D008945:Mitral Valve Prolapse / Q000188:drug therapy* / Q000503:physiopathology*; D012107:Research Design; D016896:Treatment Outcome
D000319:Adrenergic beta-Antagonists; D000889:Anti-Arrhythmia Agents; D008790:Metoprolol