Hekim KARAPNAR, Özlem Batukan ESEN, Mustafa AKÇAKOYUN, Göksel AÇAR, Selçuk PALA, Ramazan KARGIN, Hasan KAYA, Anl AVCI, Cevat KRMA, Ali Metin ESEN

Hafif-Orta Mitral Darl¤ Hastalarnda Valsartan'n Kalp Hz De¤iflkenli¤i ve Kalp Hz Toparlanmas Üzerine Etkisi

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

Anahtar Kelimeler:

Kalp hz de¤iflkenli¤i, kalp hz toparlanmas, mitral darl¤, valsartan

The Effect of Valsartanon Heart Rate Variability and Heart Rate Recovery in Patients With Mild to Moderate Mitral Stenosis

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

Keywords:

Heart rate variability, heart rate recovery, mitral stenosis, valsartan,

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ISSN: 2149-2972
Yayın Aralığı: Yılda 3 Sayı
Başlangıç: 1990
Yayıncı: Sağlık Bilimleri Üniversitesi, Kartal Koşuyolu Yüksek İhtisas Eğitim ve Araştırma Hastanesi