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Abstract
Many of the clinical features of patients with mitral valve prolapse can logically
be attributed to abnormal autonomic neural function. Accordingly, we have studied
heart rate and blood pressure response to a standardized Valsalva maneuver and postural
test in 44 untreated patients with demonstrated mitral valve prolapse. Fifteen healthy
subjects of similar age served as controls. The directional changes of blood pressure
and heart rate were similar in control subjects and patients in both tests, but patients
differed from control subjects by their widely oscillating heart rate during the upright
posture, and their exaggerated and prolonged bradycardia during the recovery phase
of the Valsalva maneuver and following their return to recumbency in the postural
test. This bradycardia persisted for 30 to 90 seconds after blood pressure returned
to control values. Patients also showed a greater respiratory variation of R-R interval,
which became especially marked during the adjustment to changes of posture. We postulate
an abnormal central modulation of baroreflexes as the best explanation for the dysautonomic
responses of symptomatic patients with prolapsed mitral valves.
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Article info
Publication history
Accepted:
April 16,
1979
Footnotes
☆This work was supported by the grants from the Social and Rehabilitation Service, Department of Health, Education, and Welfare, 13-P-55, 477; National Heart Lung and Blood Institute Program Project Grant HL11, 310; SCOR on Ischemic Heart Disease 1 P17 HL17,667 and the Rast Fund for Medical Research.
Identification
Copyright
© 1979 Published by Elsevier Inc.
