Effect of metoprolol on heart rate variability in symptomatic patients with mitral valve prolapse


TACOY G., BALCIOGLU A. S. , Arslan U., Durakoglugil E. , ERDEM G., OZDERNIR M., ...More

AMERICAN JOURNAL OF CARDIOLOGY, vol.99, no.11, pp.1568-1570, 2007 (Journal Indexed in SCI) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 99 Issue: 11
  • Publication Date: 2007
  • Doi Number: 10.1016/j.amjcard.2007.01.032
  • Title of Journal : AMERICAN JOURNAL OF CARDIOLOGY
  • Page Numbers: pp.1568-1570

Abstract

Metoprolol is widely used to eliminate symptoms in patients with mitral valve prolapse (MVP), a condition associated with enhanced sympathetic tone. In this study, effects of metoprolol on heart rate variability (HRV) indices were investigated in symptomatic patients with MVP. Thirty-nine symptomatic patients with MVP (26 women, mean age 26 +/- 7 years) and 16 age- and gender-matched controls were studied. After a baseline 24-hour Holter evaluation in all subjects, patients with,MVP were started on metoprolol succinate therapy at a dose of 25 to 100 mg/d, and Holter analysis was repeated at the end of 3 months of metoprolol therapy. At the basal evaluation, all time-domain HRV indices with the exception of proportion of adjacent RR intervals differing by > 50 ms in the 24-hour recording were significantly lower in patients with MVP than controls (SD of all normal-to-normal [NN] intervals, p = 0.013; SD of average NN intervals calculated during 5-minute periods of the entire recording, p = 0.03; triangular index, p = 0.025; and square root of mean squared differences in successive NN intervals, p = 0.026). After metoprolol treatment, all HRV indices significantly improved compared with baseline (SD of all NN intervals, p = 0.028; SD of average NN intervals calculated during 5-minute periods of the entire recording, p = 0.043; triangular index, p = 0.004; square root of the mean squared differences in successive NN intervals, p = 0.021; and proportion of adjacent RR intervals differing by > 50 ms in the 24-hour recording, p = 0.014), and HRV indices after metoprolol treatment were similar to those of the control group (p > 0.05). In conclusion, metoprolol significantly improved impaired HRV parameters in symptomatic patients with MVP. (c) 2007 Elsevier Inc. All rights reserved.