ISSN 1016-5169 | E-ISSN 1308-4488
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Assessment of autonomic dysfunction and anxiety levels in patients with mitral valve prolapse [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. 2009; 37(4): 226-233

Assessment of autonomic dysfunction and anxiety levels in patients with mitral valve prolapse

Ahmet L Orhan1, Nurten Sayar1, Zekeriya Nurkalem1, Nevzat Uslu1, İsmail Erdem1, Emine C Erdem1, Hatice B Erer1, Özer Soylu1, Ayşe Emre1, Kemal Sayar2, Mehmet Eren1
1Deparment of Cardiology, Dr. Siyami Ersek Cardiovascular Surgery Training and Research Hospital, Istanbul
2Department of Psychiatry, Bakırköy Psychiatric Disorders Hospital, İstanbul


OBJECTIVES
This study aimed to assess autonomic dysfunction parameters and anxiety levels in patients with mitral valve prolapse (MVP).

STUDY DESIGN
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).

CONCLUSION
Our data suggest that patients with MVP syndrome have increased autonomic dysfunction and anxiety scores compared to patients with anatomical MVP.

Keywords: autonomic nervous system, blood pressure, heart rate; hypotension, orthostatic; mitral valve prolapse.

How to cite this article
Ahmet L Orhan, Nurten Sayar, Zekeriya Nurkalem, Nevzat Uslu, İsmail Erdem, Emine C Erdem, Hatice B Erer, Özer Soylu, Ayşe Emre, Kemal Sayar, Mehmet Eren. Assessment of autonomic dysfunction and anxiety levels in patients with mitral valve prolapse. Turk Kardiyol Dern Ars. 2009; 37(4): 226-233

Corresponding Author: Ahmet L Orhan, Türkiye
Manuscript Language: English


Journal Metrics

Journal Citation Indicator: 0.18
CiteScore: 1.1
Source Normalized Impact
per Paper:
0.22
SCImago Journal Rank: 0.348

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