ABSTRACT

Mitral valve prolapsus has an increased risk of arrhythmia. In this study, we aimed to examine if heart rate variability is different in patients with mitral prolapsus, and if it is, the relationship between the heart rate variability and eccentric hypertrophy. Forty eight subjects were divided into four groups according to the presence or absence of eccentric hypertrophy and mitral valve prolapsus: mitral valve prolapsus and left ventricular eccentric hypertrophy positive (Group 1, n=12, 25±4 years old, male to female ratio: 4/8), mitral valve prolapsus positive and left ventricular eccentric hypertrophy negative (Group 2, n=12, 23±5 years old, male to female ratio: 5/7), mitral valve prolapsus negative and left ventricular eccentric hypertrophy positive (Group 3, n=12, 26±7 years old, male to female ratio: 7/5), and mitral valve prolapsus and left ventricular eccentric hypertrophy negative (Group 4, n=12, 24±4 years old, male to female ratio: 7/5). The patients were asked to carry Holter electrocardiography device for 24 hours in order to measure the heart rate variability. Ventricular extrasystoles and automatically estimated heart rate variability parameters of time domain were compared among the groups. Age and sex were not different among the groups. Indexes, SDANN and rMSDD, were significantly lower in the patients with left ventricular eccentric hypertrophy (Groups 1 and 3) than in the patients without eccentric hypertrophy (Groups 2 and 4) (p<0.01). In contrast, the patients with mitral prolapsus (Groups 1 and 2) showed heart rate variability indexes that were not different significantly in relation to the patients without mitral valve prolapsus (Groups 3 and 4) (p>0.01). Ventricular extrasystoles were also higher in Group 1 patients (p<0.001). If there is no eccentric hypertrophy in patients with prolapsus, heart rate variability is normal. The eccentric hypertrophy is associated with decreased heart rate variability. These patients must be followed carefully with regard to arrhythmia.