Artikel
On The Origin Of Palpitations In Patients With Mitral Valve Prolapse Syndrome. Role Of Long Term Adrenergic Beta Blockade
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Veröffentlicht: | 8. Februar 2007 |
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Question: 1.Occurrence of palpitations and rhythm disturbances in mitral valve prolapse syndrome MVPS patients (P) with high levels of catecholamines. 2.Effect of long term beta blockade on these findings.
Material and Methods: 20 normal individuals(N)–8 male(M) (49.9+-12.9y) and 12 female(F) (41.8+-11.8y). 46 P with MVPS-15 M (49.3+-15.5y) and 31 F (42.0+-12.8y). Phase1–In both N and P free of medication, determination of 24 hours urinary epinephrine (E) and norepinephrine (NE) by HPLC, and 24h Holter monitoring. Phase2–MVPS P underwent the same tests while taking Propranolol by 10-12 months.
Results: In ng/mg of creatinine, E levels in M were 5.1+-2.5(N), 9.1+-3.9(Ph1), 7.9+-3.1(Ph2). In F, 6.2+-3.5(N), 13.0+-9.7(Ph1), 10.7+-6.7(Ph2). NE levels in M were 22.2+-7.2(N), 36.8+-16.8(Ph1), 27.4+-10.6(Ph2). In F, 28.1+-7.3(N), 46.2+-18.1(Ph1), 33.0+-12.9(Ph2). Extrasystoles in 35% of the N and in 100% of MVPS. Palpitations in 25% of the N and 59% of MVPS. Episodes of palpitations in 24 hours 4.7+-5.3(M), 5.0+-4.7(F). No correlation between palpitations and extrasystoles. Correlations between: palpitations and sinus tachycardia (p=0.02),number of episodes of palpitations and E levels, extrasystoles and E levels. In phase 2, heart rate was lower than in phase1. Extrasystoles in 22% of the P. Palpitations in 52% of all P with 1.5+-1.6(M) and 1.6+-1.9(F) episodes in 24 hours. Correlations between: palpitations and sinus tachycardia (p<0.02), number of episodes of palpitations and E levels. No correlation between palpitations and extrasystoles.
Conclusions: MVPS patients had more palpitations and more extrasystoles, both correlated with the higher levels of Epinephrine. Palpitations did not correlate with extrasystoles but with sinus tachycardia. With long term beta adrenergic blockade, palpitations improved and their correlation with sinus tachycardia persisted.