• This record comes from PubMed

Complex sympathetic regulation in adolescent mitral valve prolapse

. 2021 Dec 31 ; 70 (S3) : S317-S325.

Language English Country Czech Republic Media print

Document type Journal Article

Mitral valve prolapse (MVP) belongs to cardiac disorders characterized by impaired closure of mitral leaflets. We studied adolescent group of patients with MVP suffering from symptomatology that cannot be explained by mitral regurgitation alone. Several studies suggested that symptoms can be explained by autonomic, in particular sympathetic-linked dysfunction. Thus, we assessed non-invasive sympathetic indices of blood pressure and heart rate variability and electrodermal activity (EDA). Fifty-three adolescents with MVP (age: 15.1+/-0.4 years) and 43 healthy age- and gender-matched adolescents (age: 14.9+/-0.4 years) were examined. Blood pressure, heart rate and EDA were continuously recorded during 6-min rest. Evaluated parameters were: low frequency band of systolic blood pressure variability, systolic, diastolic and mean blood pressure, mean RR interval, cardiac sympathetic indices: symbolic dynamics (0V%), left ventricular ejection time (LVET), pre-ejection period (PEP), and EDA. Our findings revealed significantly higher systolic, diastolic, and mean blood pressure values, shortened mean RR interval, increased 0V%, and shortened LVET in MVP patients vs. controls (p=0.028, p<0.001, p=0.002, p<0.001, p=0.050, p<0.001; respectively). Our study revealed enhanced cardiovascular sympathetic regulation in adolescent MVP patients. We suggest that evaluation of non-invasive sympathetic parameters could represent potential biomarkers for early diagnosis of cardiovascular complications associated with MVP already at adolescent age.

See more in PubMed

BEKETOVA GV, SOLDATOVA OV, GAN RV, HORIACHEVA IP, ALEKSIEIENKO NV, NEKHAIENKO MI, ZBORSHCHIK MV. Daily profile of blood pressure in adolescents with mitral valve prolapse. World Med Biol. 2018;14:9–12. doi: 10.26724/2079-8334-2018-3-65-9-12. DOI

BENARROCH EE. The central autonomic network: functional organization, dysfunction, and perspective. Mayo Clin Proc. 1993;68:988–1001. doi: 10.1016/S0025-6196(12)62272-1. PubMed DOI

BERNTSON GG, QUIGLEY KS, NORMAN GJ, LOZANO D. Cardiovascular psychophysiology. In: CACIOPPO JT, TASSINARY LG, BERNTSON GG, editors. Handbook of Psychophysiology. Cambridge University Press; Cambridge: 2016. pp. 183–216.

BIERING-SØRENSEN T, QUEREJETA ROCA G, HEGDE SM, SHAH AM, CLAGGETT B, MOSLEY TH, BUTLER KR, SOLOMON SD. Left ventricular ejection time is an independent predictor of incident heart failure in a community-based cohort. Eur J Heart Fail. 2018;20:1106–1114. doi: 10.1002/ejhf.928. PubMed DOI PMC

BILOVOL O, KNIAZKOVA I, MARYNA B, MISHCHENKO V, TSIHANKOV O, MAZII V. Magnesium in idiopathic mitral valve prolapse. Serbian J Exp Clin Res. 2019;21:351–359. doi: 10.2478/sjecr-2019-0026. DOI

BONA OLEXOVA L, SEKANINOVA N, JURKO A, VISNOVCOVA Z, GRENDAR M, JURKO T, TONHAJZEROVA I. Respiratory sinus arrhythmia as an index of cardiac vagal control in mitral valve prolapse. Physiol Res. 2020;69:163–169. doi: 10.33549/physiolres.934402. PubMed DOI PMC

BOUDOULAS KD, BOUDOULAS H. Floppy mitral valve (FMV)/mitral valve prolapse (MVP) and the FMV/MVP syndrome: Pathophysiologic mechanisms and pathogenesis of symptoms. Cardiology. 2013;126:69–80. doi: 10.1159/000351094. PubMed DOI

BOUDOULAS KD, PITSIS AA, BOUDOULAS H. Floppy mitral valve (FMV) - mitral valve prolapse (MVP) - mitral valvular regurgitation and FMV/MVP syndrome. Hell J Cardiol. 2016;57:73–85. doi: 10.1016/j.hjc.2016.03.001. PubMed DOI

BOUDOULAS KD, PITSIS AA, MAZZAFERRI EL, GUMINA RJ, TRIPOSKIADIS F, BOUDOULAS H. Floppy mitral valve/mitral valve prolapse: A complex entity with multiple genotypes and phenotypes. Prog Cardiovasc Dis. 2020;63:308–326. doi: 10.1016/j.pcad.2020.03.004. PubMed DOI

CHANG CJ, CHEN YC, LEE CH, YANG IF, YANG TF. Posture and gender differentially affect heart rate variability of symptomatic mitral valve prolapse and normal adults. Acta Cardiol Sin. 2016;32:467–476. doi: 10.6515/acs20150728b. PubMed DOI PMC

CORÎCI OM, TǍNASIE CA, ALEXANDRU DO, FLORESCU MC, COMǍNESCU MV, KAMAL KC, ŢENEA-COJAN TŞ, IANCǍU M, DINESCU SN. A morpho-functional study using PEP/LVET ratio and global longitudinal strain in patients with dilated cardiomyopathy. Rom J Morphol Emryol. 2018;59:93–103. PubMed

Da SILVA EP, PEDRO MM, VARELA MG, CORTEZ-DIAS N, BICHO MP, MADEIRA HC, LOPES MG. Heart rate and blood pressure in mitral valve prolapse patients: Divergent effects of long-term propranolol therapy and correlations with catecholamines. Anadolu Kardiyol Derg. 2007;7(Suppl 1):107–109. PubMed

DAMPNEY RA. Functional organization of central pathways regulating the cardiovascular system. Physiol Rev. 1994;74:323–364. doi: 10.1152/physrev.1994.74.2.323. PubMed DOI

DAWSON ME, SCHELL AM, FILION DL. The electrodermal system. In: CACIOPPO JT, TASSINARY LG, BERNTSON GG, editors. Handbook of Psychophysiology. Cambridge University Press; Cambridge, USA: 2000. pp. 200–223.

DAWSON ME, SCHELL AM, FILION DL. The electrodermal system. In: CACIOPPO JT, TASSINARY LG, BERNTSON GG, editors. Handbook of Psychophysiology. Cambridge University Press; New York, USA: 2007. pp. 159–181.

DELLING FN, GONA P, LARSON MG, LEHMAN B, MANNING WJ, LEVINE RA, BENJAMIN EJ, VASAN RS. Early expression of mitral valve prolapse in the framingham offspring: phenotypic spectrum. J Am Soc Echocardiogr. 2014;27:17–23. doi: 10.1016/j.echo.2013.09.015. PubMed DOI PMC

FIGNER B, MURPHY RO. Using skin conductance in judgment and decision making research. In: SCHUTLE-MECKLENBECK M, KUEHBERGER A, RANYARD R, editors. A Handbook of Process Tracing Methods for Decision Research. Psychology Press; New York: 2010. pp. 163–184.

FISHER JP, YOUNG CN, FADEL PJ. Central sympathetic overactivity: Maladies and mechanisms. Auton Neurosci Basic Clin. 2009;148:5–15. doi: 10.1016/j.autneu.2009.02.003. PubMed DOI PMC

GARRIDO A, DUSCHEK S, RODRÍGUEZ ÁRBOL J, GONZÁLEZ USERA I, VILA J, MATA JL. Sympathetic contributions to habituation and recovery of the cardiac defense response. Biol Psychol. 2020;151:107846. doi: 10.1016/j.biopsycho.2020.107846. PubMed DOI

GOLDSTEIN DS, BENTHO O, PARK MY, SHARABI Y. Low-frequency power of heart rate variability is not a measure of cardiac sympathetic tone but may be a measure of modulation of cardiac autonomic outflows by baroreflexes. Exp Physiol. 2011;96:1255–1261. doi: 10.1113/expphysiol.2010.056259. PubMed DOI PMC

GRILLETTI JVF, SCAPINI KB, BERNARDES N, SPADARI J, BIGONGIARI A, MAZUCHI F, DE AES, CAPERUTO EC, SANCHES IC, RODRIGUES B, De ANGELIS K. Impaired baroreflex sensitivity and increased systolic blood pressure variability in chronic post-ischemic stroke. Clinics. 2018;73:e253. doi: 10.6061/clinics/2018/e253. PubMed DOI PMC

HAN L, HO TF, YIP WC, CHAN KY. Heart rate variability of adolescents with mitral valve prolapse. J Electrocardiol. 2000;33:219–224. doi: 10.1054/jelc.2000.7661. PubMed DOI

HARTEVELD LM, NEDEREND I, TEN HARKEL ADJ, SCHUTTE NM, DE ROOIJ SR, VRIJKOTTE TGM, OLDENHOF H, POPMA A, JANSEN LMC, SUURLAND J, SWAAB H, De GEUS EJC. Maturation of the cardiac autonomic nervous system activity in adolescents and adolescents. J Am Heart Assoc. 2021;10:e017405. doi: 10.1161/JAHA.120.017405. PubMed DOI PMC

HOLZSCHNEIDER K, MULERT C. Neuroimaging in anxiety disorders. Dialogues Clin Neurosci. 2011;13:453–461. doi: 10.31887/DCNS.2011.13.4/kholzschneider. PubMed DOI PMC

HILL LK, HU DD, WILLIAMS DP, SOFLETEA G, COCHRAN J, SOLLERS JJ, THAYER JF. Effects of autonomic innervation on the heart as a function of effector tissue. Biomed Sci Instrum. 2010;46:202–207. PubMed

ITOH A, KRISHNAMURTHY G, SWANSON JC, ENNIS DB, BOTHE W, KUHL E, KARLSSON M, DAVIS LR, MILLER DC, INGELS NB. Active stiffening of mitral valve leaflets in the beating heart. Am J Physiol Heart Circ Physiol. 2009;296:H1766–H1773. doi: 10.1152/ajpheart.00120.2009. PubMed DOI PMC

JIRA M, ZAVODNA E, NOVAKOVA Z, FISER B, HONZIKOVA N. Reproducibility of blood pressure and inter-beat interval variability in man. Physiol Res. 2010;59:113–121. doi: 10.33549/physiolres.932002. PubMed DOI

KOENIG J. Neurovisceral regulatory circuits of affective resilience in youth. Psychophysiology. 2020;57:e13568. doi: 10.1111/psyp.13568. PubMed DOI

LUNG FW, CHENG CT, CHANG WT, SHU BC. Anxiety and mood disorder in young males with mitral valve prolapse. J Multidiscip Healthc. 2008;1:89–92. doi: 10.2147/JMDH.S4264. PubMed DOI PMC

MESTANIK M, MESTANIKOVA A, VISNOVCOVA Z, CALKOVSKA A, TONHAJZEROVA I. Cardiovascular sympathetic arousal in response to different mental stressors. Physiol Res. 2015;64:585–594. doi: 10.33549/physiolres.933217. PubMed DOI

MILLER MA, DUKKIPATI SR, TURAGAM M, LIAO SL, ADAMS DH, REDDY VY. Arrhythmic mitral valve prolapse: JACC review topic of the week. J Am Coll Cardiol. 2018;72:2904–2914. doi: 10.1016/j.jacc.2018.09.048. PubMed DOI

OKI T, FUKUDA N, KAWANO T, IUCHI A, TABATA T, MANABE K, KAGEJI Y, SASAKI M, YAMADA H, ITO S. Histopathologic studies of innervation of normal and prolapsed human mitral valves. J Heart Valve Dis. 1995;4:496–502. PubMed

PARK G, THAYER JF. From the heart to the mind: cardiac vagal tone modulates top-down and bottom-up visual perception and attention to emotional stimuli. Front Psychol. 2014;5:278. doi: 10.3389/fpsyg.2014.00278. PubMed DOI PMC

PORTA A, TOBALDINI E, GUZZETTI S, FURLAN R, MONTANO N, GNECCHI-RUSCONE T. Assessment of cardiac autonomic modulation during graded head-up tilt by symbolic analysis of heart rate variability. Am J Physiol Heart Circ Physiol. 2007;293:H702–H708. doi: 10.1152/ajpheart.00006.2007. PubMed DOI

POSADA-QUINTERO HF, FLORIAN JP, ORJUELA-CAÑÓN AD, ALJAMA-CORRALES T, CHARLESTON-VILLALOBOS S, CHON KH. Power spectral density analysis of electrodermal activity for sympathetic function assessment. Ann Biomed Eng. 2016;44:3124–3135. doi: 10.1007/s10439-016-1606-6. PubMed DOI

SHAFFER F, GINSBERG JP. An overview of heart rate variability metrics and norms. Front Public Health. 2017;5:258. doi: 10.3389/fpubh.2017.00258. PubMed DOI PMC

SHAH PM. Current concepts in mitral valve prolapse-diagnosis and management. J Cardiol. 2010;56:125–133. doi: 10.1016/j.jjcc.2010.06.004. PubMed DOI

SHAH SN, GANGWANI MK, OLIVER TI. StatPearls [Internet] Treasure Island (FL): StatPearls Publishing; 2020. Mitral Valve Prolapse. PubMed

SILVA LEV, GERALDINI VR, De OLIVEIRA BP, SILVA CAA, PORTA A, FAZAN R. Comparison between spectral analysis and symbolic dynamics for heart rate variability analysis in the rat. Sci Rep. 2017;7:1–8. doi: 10.1038/s41598-017-08888-w. PubMed DOI PMC

STAUSS HM. Identification of blood pressure control mechanisms by power spectral analysis. Clin Exp Pharmacol Physiol. 2007;34:362–368. doi: 10.1111/j.1440-1681.2007.04588.x. PubMed DOI

TAVAKOLIAN K. Systolic time intervals and new measurement methods. Cardiovasc Eng Technol. 2016;7:118–125. doi: 10.1007/s13239-016-0262-1. PubMed DOI

THAYER JF, LANE RD. A model of neurovisceral integration in emotion regulation and dysregulation. J Affect Disord. 2000;61:201–216. doi: 10.1016/S0165-0327(00)00338-4. PubMed DOI

THEOFILOGIANNAKOS EK, BOUDOULAS KD, GAWRONSKI BE, LANGAEE TY, DARDAS PS, NINIOS V, KELPIS TG, JOHNSON JA, PITSIS AA, BOUDOULAS H. Floppy mitral valve/mitral valve prolapse syndrome: Beta-adrenergic receptor polymorphism may contribute to the pathogenesis of symptoms. J Cardiol. 2015;65:434–438. doi: 10.1016/j.jjcc.2014.07.020. PubMed DOI

TONHAJZEROVA I, FARSKY I, MESTANIK M, VISNOVCOVA Z, MESTANIKOVA A, HRTANEK I, ONDREJKA I. Symbolic dynamics of heart rate variability - A promising tool to investigate cardiac sympathovagal control in attention deficit/hyperactivity disorder (ADHD)? Can J Physiol Pharmacol. 2016;94:579–587. doi: 10.1139/cjpp-2015-0375. PubMed DOI

VENABLES PH, GARTSHORE SA, O’RIORDAN PW. The function of skin conductance response recovery and rise time. Biol Psychol. 1980;10:1–6. doi: 10.1016/0301-0511(80)90002-2. PubMed DOI

VISNOVCOVA Z, MESTANIK M, JAVORKA M, MOKRA D, GALA M, JURKO A, CALKOVSKA A, TONHAJZEROVA I. Complexity and time asymmetry of heart rate variability are altered in acute mental stress. Physiol Meas. 2014;35:1319–1334. doi: 10.1088/0967-3334/35/7/1319. PubMed DOI

WILLIAMS TH, JEW JY. Is the mitral valve passive flap theory overstated? An active valve is hypothesized. Med Hypotheses. 2004;62:605–611. doi: 10.1016/j.mehy.2003.12.001. PubMed DOI

ZHANG R, IWASAKI K, ZUCKERMAN JH, BEHBEHANI K, CRANDALL CG, LEVINE BD. Mechanism of blood pressure and R-R variability: insights from ganglion blockade in humans. J Physiol. 2002;543:337–348. doi: 10.1113/jphysiol.2001.013398. PubMed DOI PMC

Find record

Citation metrics

Loading data ...

Archiving options

Loading data ...