title: Assessment of autonomic dysfunction and anxiety levels in patients with mitral valve prolapse.
abstract: OBJECTIVE
  This study aimed to assess autonomic dysfunction parameters and anxiety levels in patients with mitral valve prolapse (MVP).
  
  
  METHODS
  We evaluated 33 patients (mean age 25+/-5 years) with MVP and 14 healthy subjects (mean age 25+/-4 years). The patients were divided into two groups according to the presence (anatomical MVP, n=11) or absence (MVP syndrome, n=22) of abnormal leaflet thickening (>5 mm). Spielberger's Situational Anxiety Scale (SSAS) and Continuous Anxiety Scale (SCAS) were administered to all the subjects, and heart rates (HR) and arterial blood pressures (BP) were measured in the supine and standing positions.
  
  
  RESULTS
  Mid-systolic click and late systolic murmur were significantly more frequent in patients with anatomical MVP, while nonspecific symptoms such as dyspnea, vertigo, and atypical chest pain were more frequent in patients with MVP syndrome (p<0.05). Mitral insufficiency (mild) was significantly more frequent in patients with anatomical MVP (72.7% vs. 22.7%; p<0.009). Patients with MVP syndrome had significantly higher SSAS and SCAS scores (41.0+/-15.6 and 38.5+/-15.5) compared to patients with anatomical MVP (15.8+/-7.5 and 17.0+/-9.1) and controls (14.9+/-7.4 and 16.9+/-8.7, respectively; for both p<0.001). Orthostatic differences in BP and HR were significantly greater in patients with MVP syndrome than those having anatomical MVP (p<0.001 and p=0.032, respectively). Orthostatic HR differences showed a significant correlation with SSAS in both MVP groups (r=0.536, p=0.001) and a significant correlation with SCAS in patients with MVP syndrome (r=0.523, p=0.002). There was an inverse correlation between orthostatic BP differences and anxiety parameters in all MVP patients (r=-0.391, p=0.025 for SSAS, and r=-0.320, p=0.048 for SCAS).
  
  
  CONCLUSIONS
  Our data suggest that patients with MVP syndrome have increased autonomic dysfunction and anxiety scores compared to patients with anatomical MVP.
authors.affiliation: Department of Cardiology, Siyami Ersek Cardiovascular Surgery Center, Istanbul, Turkey. lutfu.orhan@yahoo.com
authors.forename: Ahmet L
authors.initials: AL
authors.lastname: Orhan
authors.forename: Nurten
authors.initials: N
authors.lastname: Sayar
authors.forename: Zekeriya
authors.initials: Z
authors.lastname: Nurkalem
authors.forename: Nevzat
authors.initials: N
authors.lastname: Uslu
authors.forename: Ismail
authors.initials: I
authors.lastname: Erdem
authors.forename: Emine C
authors.initials: EC
authors.lastname: Erdem
authors.forename: Hatice B
authors.initials: HB
authors.lastname: Erer
authors.forename: Ozer
authors.initials: O
authors.lastname: Soylu
authors.forename: Ayşe
authors.initials: A
authors.lastname: Emre
authors.forename: Kemal
authors.initials: K
authors.lastname: Sayar
authors.forename: Mehmet
authors.initials: M
authors.lastname: Eren
mesh_terms: D000328:Adult; D001007:Anxiety; D001342:Autonomic Nervous System Diseases / Q000503:physiopathology / Q000523:psychology; D001794:Blood Pressure; D004562:Electrocardiography; D005260:Female; D006337:Heart Murmurs / Q000503:physiopathology / Q000523:psychology; D006339:Heart Rate; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008945:Mitral Valve Prolapse / Q000503:physiopathology* / Q000523:psychology*; D011569:Psychiatric Status Rating Scales; D012016:Reference Values; D013599:Systole; D055815:Young Adult