EVALUATION OF CARDIAC AUTONOMIC DYSFUNCTION AND THE RISK OF ARRHYTHMIA IN CHILDREN WITH MITRAL VALVE PROLAPSE

Yıl 2023, Cilt: 6 Sayı: 2, 290 - 296, 30.06.2023

Abdullah Bindal Murat Deveci

https://doi.org/10.53446/actamednicomedia.1292677

Öz

Objective: The occurrence of symptoms in patients with mitral valve prolapse (MVP) is linked to autonomic dysfunction and neuroendocrine causes rather than progressive mitral valve insufficiency. The goal was to assess the risk of autonomic dysfunction and arrhythmia in patients with MVP.
Methods: The study included 63 patients with primary MVP and a control group of 64 children of similar age and gender. Following a physical examination, all patients' histories were taken, and 12-lead ECGs, autonomic function tests, echocardiography, and 24-hour Holter rhythm studies were performed.
Results: The patient group had a higher mean resting heart rate than the control group. Orthostatic hypotension was found in 8 patients (12.6%) and 4 children (6.2%) in the control group. When compared to the control group, patients with MVP had higher QTc dispersion, frontal QRS-T angle, Tp-e interval, and Tp-e/QTc ratio. There was no significant difference between the two groups in terms of conventional measurements of heart rate variability in the Holter ECG, as well as no significant difference in HRDC.
Conclusion: Although cases with pathological findings in the initial ECG were excluded from our study, we believe that the high frontal QRS-T angle observed in MVP patients is a novel and significant finding. Furthermore, it has been discovered that HRDC, a new and understudied parameter in children, does not show a significant difference in patients with MVP.

Anahtar Kelimeler

Mitral valve prolapse, autonomic dysfunction, arrhythmia

Destekleyen Kurum

None

Proje Numarası

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Teşekkür

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MİTRAL KAPAK PROLAPSUSU OLAN ÇOCUKLARDA KARDİYAK OTONOMİK DİSFONKSİYONUN VE ARİTMİ RİSKİNİN DEĞERLENDİRİLMESİ

Öz

Amaç: Mitral kapak prolapsusu (MKP) saptanan olgularda yakınmaların ortaya çıkışı ilerleyici mitral kapak yetersizliğinden çok otonomik işlev bozukluğu ve nöroendokrin nedenlere bağlıdır. Bu çalışmada MKP tanısı ile izlenen çocukların otonomik disfonksiyon ve aritmi riski açısından değerlendirilmesi amaçlanmıştır.
Yöntem: Çalışmaya primer MKP tanılı 63 hasta ve benzer yaş ve cinsiyetteki 64 çocuktan oluşan kontrol grubu dahil edildi. Tüm hastaların öyküleri alındı, fizik muayeneleri yapıldıktan sonra; 12 derivasyonlu EKG’leri, otonom işlev testleri, ekokardiyografi 24-saatlik ritim Holter incelemeleri gerçekleştirildi.
Bulgular: Ortalama dinlenme kalp hızı, hasta grubunda kontrol grubuna göre daha yüksek bulundu. Ortostatik hipotansiyon hasta grubunda 8 çocukta (%12,6), kontrol grubunda ise 4 çocukta (%6,2) saptandı. Yüzeyel EKG’de QTc dispersiyonu, frontal QRS-T açısı, Tp-e aralığı ve Tp-e/QTc oranı MKP’li hastalarda kontrol grubuna göre yüksek saptandı. Holter EKG’de kalp hızı değişkenliğini gösteren konvansiyonel ölçümler açısından iki grup arasında anlamlı fark saptanmadığı gibi HRDC açısından da iki grup arasında anlamlı fark saptanmadı.
Sonuç: Çalışmamıza başlangıç EKG'sinde patolojik bulgusu olan olgular dâhil edilmemesine rağmen MKP'li hastalarda yüksek frontal QRS-T açısının tespit edilmiş olmasının yeni ve önemli bir bulgu olduğunu düşünmekteyiz. Ayrıca yeni ve çocuklarda az çalışılmış bir parametre olan HRDC’nin MKP’ li hastalarda anlamlı farklılık göstermediği ortaya çıkmış olup bununla ilgili daha fazla çalışmaya ihtiyaç vardır.

Anahtar Kelimeler

Mitral kapak prolapsusu, otonom disfonksiyon, aritmi, çocuk

Proje Numarası

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Kaynakça

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