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Depression of cardiovascular autonomic function is more pronounced after mitral valve surgery : evidence for direct trauma

  • The analysis of baroreflex sensitivity (BRS) and heart rate variability (HRV) leads to additional insights into patients' prognosis after cardiovascular events. The following study was performed to assess the differences in the post-operative recovery of autonomic regulation after mitral valve (MV) and aortic valve (AV) surgery with a heart lung machine. Among the 43 consecutive male patients enrolled in a prospective study, 26 underwent isolated AV surgery and 17 isolated MV surgery. Blood pressure as well as ECG signals were recorded the day before, 24 hours after and one week after surgery. BRS was calculated according to the dual sequence method, and HRV was calculated using standard linear as well as nonlinear parameters. There were no major differences between the two groups in the pre-operative values. At 24 hours a comparable depression of HRV and BRS in both groups was observed, while at 7 days there was partial recovery in AV patients, which was absent in MV patients: p(AV versus MV) < 0.001. While the response of theThe analysis of baroreflex sensitivity (BRS) and heart rate variability (HRV) leads to additional insights into patients' prognosis after cardiovascular events. The following study was performed to assess the differences in the post-operative recovery of autonomic regulation after mitral valve (MV) and aortic valve (AV) surgery with a heart lung machine. Among the 43 consecutive male patients enrolled in a prospective study, 26 underwent isolated AV surgery and 17 isolated MV surgery. Blood pressure as well as ECG signals were recorded the day before, 24 hours after and one week after surgery. BRS was calculated according to the dual sequence method, and HRV was calculated using standard linear as well as nonlinear parameters. There were no major differences between the two groups in the pre-operative values. At 24 hours a comparable depression of HRV and BRS in both groups was observed, while at 7 days there was partial recovery in AV patients, which was absent in MV patients: p(AV versus MV) < 0.001. While the response of the autonomic system to surgery is similar in AV and MV patients, there is obviously a decreased ability to recover in MV patients, probably attributed to traumatic lesions of the autonomic nervous system by opening the atria. Ongoing research is required for further clarification of the pathophysiology of this phenomenon and to establish strategies to restore autonomic function.show moreshow less

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Metadaten
Author:Beatrice Retzlaff, Robert Bauernschmitt, Hagen Malberg, Gernot Brockmann, Christian Uhl, Ruediger Lange, Jürgen KurthsORCiDGND, Georg Bretthauer, Niels Wessel
URL:http://rsta.royalsocietypublishing.org/
DOI:https://doi.org/10.1098/rsta.2008.0272
ISSN:1364-503X
Document Type:Article
Language:English
Year of first Publication:2009
Year of Completion:2009
Release Date:2017/03/25
Source:Philosophical transactions of the Royal Society A. - ISSN 1364-503X. - 367 (2009), 1892, S. 1251 - 1263
Organizational units:Zentrale und wissenschaftliche Einrichtungen / Interdisziplinäres Zentrum für Dynamik komplexer Systeme
Peer Review:Referiert