Hafif-Orta Mitral Darl›¤› Hastalar›nda Valsartan'›n Kalp H›z› De¤iflkenli¤i ve Kalp H›z› Toparlanmas› Üzerine Etkisi

Amaç: Atriyal fibrilasyon (AF) mitral darl›¤› (MD)'nin önemli bir komplikasyonudur. AF gelifliminde otonom sinir sisteminin etkili oldu¤u, kalp h›z› de¤iflkenli¤i (KHD) ve kalp h›z› toparlanmas› (KHT)'n›n otonom sinir sisteminin göstergesi oldu¤u ve MD hastalar›nda bozuldu¤u bildirilmifltir. Çal›flmam›zda MD hastalar›nda Valsartan'›n KHD ve KHT üzerine, dolay›s›yla otonom sinir sistemi üzerine etkilerini araflt›rd›k. Yöntem: Hafif-orta MD olan 11 hasta (39±8 y›l, 10 kad›n) çal›flmaya al›nd›. Yafl ve cins olarak efllefltirilmifl 16 gönüllü (38±8 y›l, 14 kad›n) kontrol gurubu olarak seçildi. Tüm popülasyona transtorasik ekokardiyografi (TTE), semptomla s›n›rl› egzersiz testi ve 24 saatlik holter incelemesi yap›ld›. 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 yap›ld›. Bulgular: Tedavi öncesinde KHT ve KHD parametreleri bak›m›ndan hasta gurubu ile kontrol gurubu aras›nda önemli bir fark saptanmad›. Valsartan tedavisi sonras›nda hastalar›n sistolik (117±6 karfl›n 107±4 mmHg p

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

Kaynakça

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