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Europace Advance Access originally published online on September 4, 2008
Europace 2008 10(12):1434-1441; doi:10.1093/europace/eun251
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2008. For permissions please email: journals.permissions@oxfordjournals.org

Non-invasive electrophysiology

Heart rate variability and heart rate turbulence in mild-to-moderate aortic stenosis

Ugur Arslan*, Murat Özdemir, Sinan Altan Kocaman, Serhat Balcioglu, Mustafa Cemri and Atiye Çengel

Department of Cardiology, Faculty of Medicine, Gazi University, Ankara, Turkey

Aims: To study heart rate (HR) variability and HR turbulence parameters in mild-to-moderate aortic stenosis (AS) and to disclose whether any relationship exists between these parameters and echocardiographic findings.

Methods and results: Forty-three asymptomatic patients with mild-to-moderate AS (AS group) were studied. Echocardiographic parameters and HR variability and HR turbulence indices obtained over 24 Holter ECG recordings were compared with those of an age and sex matched control population free of cardiovascular disease. Correlation between echocardiographic findings and HR variability and HR turbulence indices was also studied in the AS group. All HR variability parameters except mean RR interval, RMSSD, and pNN50 and one HR turbulence parameter, turbulence onset, were significantly disturbed in the AS group. Echocardiographic findings of diastolic dysfunction had significant correlations with HR variability and HR turbulence parameters in AS patients.

Conclusion: Symphatovagal imbalance as shown by disturbed HR variability and HR turbulence parameters was demonstrated for the first time in patients with mild-to-moderate AS. This imbalance, which was shown to be correlated with echocardiographic findings of diastolic dysfunction, may lead to arrhythmic complications in this seemingly low-risk patient population.

Key Words: Aortic stenosis, Diastolic dysfunction, Heart rate variabilty, Heart rate turbulence, Sympatovagal imbalance

* Corresponding author. Güvenlik Caddesi, no: 38/4 A. Ayranci, Ankara, Turkey. Tel: +90 532 6039983; fax: +90 312 2129012. E-mail address: ugurarslan5{at}yahoo.com

Manuscript submitted 3 July 2008. Accepted after revision 13 August 2008.


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