Dergiler / Koşuyolu Heart Journal / 2010 / Cilt: 13 - Sayı: 1
Hafif-Orta Mitral Darl¤ Hastalarnda Valsartan'n Kalp Hz De¤iflkenli¤i ve Kalp Hz Toparlanmas Üzerine Etkisi
- Sayfa
- 11–15
- DOI
- —
Özet
Amaç: Atriyal fibrilasyon (AF) mitral darl¤ (MD)'nin önemli bir komplikasyonudur. AF gelifliminde otonom sinir sisteminin etkili oldu¤u, kalp hz de¤iflkenli¤i (KHD) ve kalp hz toparlanmas (KHT)'nn otonom sinir sisteminin göstergesi oldu¤u ve MD hastalarnda bozuldu¤u bildirilmifltir. Çalflmamzda MD hastalarnda Valsartan'n KHD ve KHT üzerine, dolaysyla otonom sinir sistemi üzerine etkilerini arafltrdk. Yöntem: Hafif-orta MD olan 11 hasta (39±8 yl, 10 kadn) çalflmaya alnd. Yafl ve cins olarak efllefltirilmifl 16 gönüllü (38±8 yl, 14 kadn) kontrol gurubu olarak seçildi. Tüm popülasyona transtorasik ekokardiyografi (TTE), semptomla snrl egzersiz testi ve 24 saatlik holter incelemesi yapld. Hastalar 14 hafta boyunca günde 160 mg Valsartan ile tedavi edildi. Tedavi sonunda TTE, egzersiz testi ve holter incelemesi tekrarland. Holter incelemesinde frekans ve zaman iliflkili alan KHD analizi, egzersiz testinde birinci ve üçüncü dakika analizi yapld. Bulgular: Tedavi öncesinde KHT ve KHD parametreleri bakmndan hasta gurubu ile kontrol gurubu arasnda önemli bir fark saptanmad. Valsartan tedavisi sonrasnda hastalarn sistolik (117±6 karfln 107±4 mmHg p
Abstract
Summary: Atrial fibrillation (AF) is known to be one of the most important complications of mitral stenosis (MS). It has been reported that autonomic nervous system (ANS) had an effect on AF development, heart rate variability (HRV) and heart rate recovery (HRR) were under the control of ANS, and their disorders were present in MS. We studied the effect of Valsartan on HRV and HRT, and thus its effect on ANS. Methods: Eleven patients (39±8 years, 10 females) with mild to moderate MS were included in the study. Sixteen volunteers (38±8 years, 14 females) matched for age and sex were selected for control group. All subjects underwent transthoracic echocardiography (TTE), symptom-limited treadmill test and 24 hour Holter monitorization. The patients were administered 160 mg of Valsartan daily for 14 weeks. TTE, treadmill test and Holter monitorization were repeated at the end of treatment period. In Holter monitorization, the time and frequency domain analysis of HRV and in exercise test, HRR at first and third minutes (HRR1 and HRR3) were examined. Results: Before Valsartan treatment, no significant difference was found in HRR and HRV parameters between the two groups. Systolic and diastolic blood pressure, and also HRR1values were significantly decreased after treatment of Valsartan (117±6 vs. 107±4 mmHg p