Comparision of Heart Rate Variability in Patients with and without Mitral Anulus Calcification

Abstract: Mitral annular calcification (MAC) is a common finding in elderly patients and is considered as a manifestation of cardiovascular disease. Analysis of heart rate variability (HRV) and heart rate turbulance (HRT) provides an indication of sympathic and vagal activity that has provided clinical and prognostic relevance to heart disease. The aim of the present study was to investigate HRV and HRT in patients with MAC and their relations to echocardiographic parameters of the same patients.Method: Fourty patients with MAC (22 female, 18 male, mean age 61±8) and fourty normal volunteers (21 female, 19 male, mean age 57±7) were studied. The clinical examination included an 24-hour ECG recording for the measurements of time and frequency domain HRV parameters and transthoracic echocardiography for the measurements of left ventricular diastolic parameters.Results: All the time domain variables except mean RR intervals and RMSSD significantly decreased in the MAC group (SDNN 116±34 p<0,001; SDANN 103±34 p<0,001; SDNN index 45±13 p<0,001; pNN50 7,2±6,6 p<0,005 ). Of all frequency domain parameters, LF, LFnu and HF was found to suppressed in the MAC group (LF 389±305 p<0,001; LFnu 17±5 p=0,001; HF 144±108 p=0,002). These findings suggest that sympathetic tone is high and parasympathetic tone is low among patients with MAC. There was no significant difference in HRT among groups. There was a strong relation between E/A ratio and Em velocity and HRV parameters.Conclusion:İn patients with MAC, HRV is reduced, and this finding asociated with increased risk of mortality.