Sympathetic overactivity in patients with pulmonary stenosis and improvement after percutaneous balloon valvuloplasty.
OBJECTIVE
Percutaneous balloon valvulotomy (PBV) is the procedure of choice for the treatment of valvular pulmonary stenosis (PS) with similar results comparable to surgical valvotomy but less invasive.


RESULTS
Twenty-seven consecutive patients with PS being evaluated for PBV were enrolled in the study. Peak instantaneous transvalvular gradient, right ventricle (RV) diameter, mean atrial pressures, RV systolic pressure (RVSP), pro-brain natriuretic peptide (proBNP) levels significantly decreased immediately after PBV. Regarding heart rate variability (HRV) parameters, mean HR (heart rate), LF (low frequency) day and night, LF/HF day and night significantly decreased and standard deviation of all NN intervals (SDNN), root mean square of successive differences (RMSSD), P number of NN intervals that differed by more than 50 ms from adjacent interval divided by the total number of all NN intervals (PNN50), HF (High frequency) day and night significantly increased 1 day after PBV and these changes were shown to be preserved at the first month. The increase in SDNN was correlated with the decrease in right atrial pressure (RAP) (r =-0.5, P = 0.04); the increase in standard deviation of the 5-minute mean RR intervals (SDANN) was correlated with the decrease in proBNP (r =-0.4, P = 0.03).


CONCLUSIONS
Sympathetic overactivity and increased proBNP levels were associated with the symptomatic status of patients with PS. Associated with a decrease in atrial pressures and proBNP levels, PBV yielded a decrease in adrenergic overactivity in the patients with PS.
Alyan
Omer
O
Dicle University Faculty of Medicine, Department of Cardiology, Diyarbakir, Turkey. droalyan@yahoo.com
Ozdemir
Ozcan
O
Kacmaz
Fehmi
F
Topaloglu
Serkan
S
Ozbakir
Cemal
C
Gozu
Ayfer
A
Korkmaz
Sule
S
Toprak
Nizamettin
N
D000293:Adolescent; D000328:Adult; D001342:Autonomic Nervous System Diseases / Q000209:etiology / Q000503:physiopathology*; D016022:Case-Control Studies; D002404:Catheterization / Q000379:methods*; D016009:Chi-Square Distribution; D002648:Child; D015331:Cohort Studies; D017548:Echocardiography, Transesophageal; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006334:Heart Function Tests; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D016015:Logistic Models; D008297:Male; D011666:Pulmonary Valve Stenosis / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D018570:Risk Assessment; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D013564:Sympathetic Nervous System / Q000503:physiopathology; D016896:Treatment Outcome