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Relation between sympathetic overactivity and left atrial spontaneous echo contrast in patients with mitral stenosis and sinus rhythm.
Heart Lung Circ. 2006 Aug; 15(4):242-7.HL

Abstract

BACKGROUND

Spontaneous echo contrast (SEC) is common in patients with mitral stenosis (MS) and presence of SEC in left atrium (LA) is associated with a higher risk of thromboembolism. Recently, an increase in activation of platelets was demonstrated in patients with SEC raising the hypothesis that platelets are involved in the pathogenesis of SEC. In this study, we evaluated effects of autonomic nervous system activity on SEC formation in patients with rheumatic MS and sinus rhythm by heart rate variability analysis.

METHODS AND RESULTS

Twenty-six patients with LASEC were compared with 28 patients without LASEC. Mean heart rate, low frequency (LF) and low frequency/high frequency (LF/HF) ratio were significantly higher, standard deviation of all NN (SDNN), root mean square of successive differences (RMSSD), number of NN intervals that differed by more than 50 ms from adjacent interval divided by the total number of all NN intervals (PNN50) and high frequency (HF) values were lower in the patients with LASEC. A standard deviation of all NN intervals <90ms separated the patients with LASEC from control subjects with a sensitivity of 77% and specificity of 90%; a low frequency >79.5 with a sensitivity of 92% and specificity of 90; a low frequency/high frequency ratio >3.7 with a sensitivity of 96% and specificity of 90%. A left atrial diameter >4.3 cm increased the LASEC formation by 3.0 folds, HR >78 beats/min by 6.4 folds, standard deviation of all NN intervals <90 ms by 9.2 folds, a low frequency/high frequency ratio >3.7 by 6.4 folds, sP-selectin>142 by 5.8 folds. Variables affecting sP-selectin levels were LA diameter, mitral valve area, transmitral mean gradient, left ventricular ejection fraction, the presence of mitral regurgitation, HR, standard deviation of all NN intervals, low frequency, high frequency and low frequency/high frequency ratio.

CONCLUSION

Sympathetic overactivity and reduced heart rate variability are important determinants for LASEC formation and increased s-P selectin levels. Therefore, platelet activation via increased sympathetic activity may play an important role in pathogenesis of LASEC.

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Publisher Full Text

Authors+Show Affiliations

Ozdemir O
Türkiye Yüksek Ihtisas Hospital, Cardiology Clinics, Ankara, Turkey. drozdemir75@yahoo.com
Alyan O
No affiliation info available
Soylu M
No affiliation info available
Topaloglu S
No affiliation info available
Aras D
No affiliation info available
Metin F
No affiliation info available
Geyik B
No affiliation info available
Ozbakir C
No affiliation info available
Demir AD
No affiliation info available

MeSH

AdultAutonomic Nervous SystemCase-Control StudiesEchocardiographyFemaleGene Expression RegulationHeart AtriaHeart RateHumansMaleMitral Valve StenosisP-SelectinPeriodicityPlatelet ActivationRisk FactorsSensitivity and SpecificitySinoatrial NodeSympathetic Nervous System

Pub Type(s)

Journal Article

Language

eng

PubMed ID

16860607

Citation

Ozdemir, Ozcan, et al. "Relation Between Sympathetic Overactivity and Left Atrial Spontaneous Echo Contrast in Patients With Mitral Stenosis and Sinus Rhythm." Heart, Lung & Circulation, vol. 15, no. 4, 2006, pp. 242-7.
Ozdemir O, Alyan O, Soylu M, et al. Relation between sympathetic overactivity and left atrial spontaneous echo contrast in patients with mitral stenosis and sinus rhythm. Heart Lung Circ. 2006;15(4):242-7.
Ozdemir, O., Alyan, O., Soylu, M., Topaloglu, S., Aras, D., Metin, F., Geyik, B., Ozbakir, C., & Demir, A. D. (2006). Relation between sympathetic overactivity and left atrial spontaneous echo contrast in patients with mitral stenosis and sinus rhythm. Heart, Lung & Circulation, 15(4), 242-7.
Ozdemir O, et al. Relation Between Sympathetic Overactivity and Left Atrial Spontaneous Echo Contrast in Patients With Mitral Stenosis and Sinus Rhythm. Heart Lung Circ. 2006;15(4):242-7. PubMed PMID: 16860607.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Relation between sympathetic overactivity and left atrial spontaneous echo contrast in patients with mitral stenosis and sinus rhythm. AU - Ozdemir,Ozcan, AU - Alyan,Omer, AU - Soylu,Mustafa, AU - Topaloglu,Serkan, AU - Aras,Dursun, AU - Metin,Fatma, AU - Geyik,Bilal, AU - Ozbakir,Cemal, AU - Demir,Ahmet Duran, Y1 - 2006/07/24/ PY - 2005/08/29/received PY - 2006/03/28/accepted PY - 2006/7/25/pubmed PY - 2006/12/15/medline PY - 2006/7/25/entrez SP - 242 EP - 7 JF - Heart, lung & circulation JO - Heart Lung Circ VL - 15 IS - 4 N2 - BACKGROUND: Spontaneous echo contrast (SEC) is common in patients with mitral stenosis (MS) and presence of SEC in left atrium (LA) is associated with a higher risk of thromboembolism. Recently, an increase in activation of platelets was demonstrated in patients with SEC raising the hypothesis that platelets are involved in the pathogenesis of SEC. In this study, we evaluated effects of autonomic nervous system activity on SEC formation in patients with rheumatic MS and sinus rhythm by heart rate variability analysis. METHODS AND RESULTS: Twenty-six patients with LASEC were compared with 28 patients without LASEC. Mean heart rate, low frequency (LF) and low frequency/high frequency (LF/HF) ratio were significantly higher, standard deviation of all NN (SDNN), root mean square of successive differences (RMSSD), number of NN intervals that differed by more than 50 ms from adjacent interval divided by the total number of all NN intervals (PNN50) and high frequency (HF) values were lower in the patients with LASEC. A standard deviation of all NN intervals <90ms separated the patients with LASEC from control subjects with a sensitivity of 77% and specificity of 90%; a low frequency >79.5 with a sensitivity of 92% and specificity of 90; a low frequency/high frequency ratio >3.7 with a sensitivity of 96% and specificity of 90%. A left atrial diameter >4.3 cm increased the LASEC formation by 3.0 folds, HR >78 beats/min by 6.4 folds, standard deviation of all NN intervals <90 ms by 9.2 folds, a low frequency/high frequency ratio >3.7 by 6.4 folds, sP-selectin>142 by 5.8 folds. Variables affecting sP-selectin levels were LA diameter, mitral valve area, transmitral mean gradient, left ventricular ejection fraction, the presence of mitral regurgitation, HR, standard deviation of all NN intervals, low frequency, high frequency and low frequency/high frequency ratio. CONCLUSION: Sympathetic overactivity and reduced heart rate variability are important determinants for LASEC formation and increased s-P selectin levels. Therefore, platelet activation via increased sympathetic activity may play an important role in pathogenesis of LASEC. SN - 1443-9506 UR - https://www.unboundmedicine.com/medline/citation/16860607/Relation_between_sympathetic_overactivity_and_left_atrial_spontaneous_echo_contrast_in_patients_with_mitral_stenosis_and_sinus_rhythm_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1443-9506(06)00076-X DB - PRIME DP - Unbound Medicine ER -