HRV AND HRT
Heart rate turbulence and heart rate variability in patients with mitral valve prolapse
1 Faculty of Medicine, Department of Cardiology, Abant 
zzet Baysal University, zzet Baysal, 14280 Bolu, Turkey ;
2 Faculty of Medicine, Department of Cardiology, Abant zzet Baysal University, Duzce, 81620 Duzce, Turkey
Aims Heart rate turbulence (HRT) and heart rate variability (HRV) have been shown to be independent and powerful predictors of mortality in a specific group of cardiac patients. However, the predictive valsue of HRV alone is modest and information on HRV in patients with mitral valve prolapse (MVP) has so far been conflicting. In addition, no studies have previously evaluated HRT in patients with MVP. To define better the effects of MVP on cardiac autonomic function, we assessed HRT and time-domain parameters of HRV in patients with MVP.
Methods and results Fifty patients with MVP and 70 controls without MVP were investigated. The diagnosis of MVP was confirmed by cross-sectional echocardiography in the parasternal long-axis view and apical 4-chamber view. The HRV and turbulence analysis were assessed from a 24-hour Holter recording. When HRT parameters were compared, the values of the HRT onset and slope were significantly lower in MVP patients than in the controls group (–0.109±0.207 vs. –0.289±0.170%, P=0.001 and 8.6±7.2 vs. 11.5±7.4 ms/RRI, P=0.043, respectively) and the number of patients who had abnormal HRT onset was significantly higher in the MVP group than in controls (15 vs. 8, P=0.011). In addition, HRV parameters were not statistically different between the two groups.
Conclusion Although we found that the decrease in HRV parameters was not significantly different between MVP patients and controls, HRT variables (especially HRT onset) were significantly lower in MVP patients. Therefore, in our opinion, HRT is an attractive, easily applicable, and better way of non-invasive risk prediction compared with another non-invasive risk predictor, HRV.
Key Words: Mitral valve prolapse, Heart rate turbulence
* Corresponding author. Eski Istanbul Caddesi, Bahcelievler Mahallesi, Karsu Apartmani, 11/1 14070 Bolu, Turkey. Tel: +90 3742176520; fax: +90 3742175061. E-mail address: drhuseyingunduz{at}yahoo.com
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  A. Bauer, M. Malik, G. Schmidt, P. Barthel, H. Bonnemeier, I. Cygankiewicz, P. Guzik, F. Lombardi, A. Muller, A. Oto, et al. Heart Rate Turbulence: Standards of Measurement, Physiological Interpretation, and Clinical Use: International Society for Holter and Noninvasive Electrophysiology Consensus J. Am. Coll. Cardiol., October 21, 2008; 52(17): 1353 - 1365. [Abstract] [Full Text] [PDF]
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