Heart rate variability in patients after cardiac valve surgery

Abstract

<jats:title>Abstract</jats:title><jats:p>The aim of study was to analyze heart rate variability (HRV) after different cardiac valve surgery procedures and the prognostic values of these findings. This study included 101 consecutive patients who underwent surgical implantation for an artificial valve. The mean age of the patients was 62 ± 10 years. An aortic valve was implanted in 65 patients. A mitral valve was implanted in 36 patients. HRV was analyzed from 24 hours Holter electrocardiographic (ECG) records. The time from the operation to the recording of Holter ECG and measuring HRV was 3.8 ± 1.4 months. After discharged from stationary cardiac rehabilitation, all involved patients were contacted to provide data on their health in the follow-up period (33 ± 21 months). A total of 46 patients with an implanted artificial valve had decreased overall HRV or standard deviation of all normal R-R intervals (SDNN) &lt; 93 ms. Patients with an implanted artificial mitral valve had a shorter RR interval (817 ± 122 vs. 863 ± 122ms, p=0.03) and lower values of total power (1166 ± 1888 vs. 2802 ± 3601 ms2, p&lt;0.001) compared to patients with an implanted artificial aortic valve. The results of study show that several months after cardiac surgery, almost half of the patients with an implanted artificial valve have decreased HRV. However, postoperative decreased HRV in those patients have no importance in long-term prediction of mortality rate.</jats:p>

Effect of a Percutaneous Coronary Intervention Procedure on Heart Rate Variability and Pulse Transit Time Variability: A Comparison Study Based on Fuzzy Measure Entropy

“…Moreover, many studies have demonstrated that coronary artery bypass grafting (CABG) also leads to significant HRV reduction, which is even more pronounced than after myocardial infarction [10][11][12][13]. In addition, HRV reduction after cardiac surgery is not exclusively related to PCI or CABG, as it is also recorded in patients undergoing valve surgery [14]. Unlike myocardial infarction where the main reason of the HRV reduction is ischaemia and myocyte necrosis, the probable reasons for considerable HRV reduction immediately after PCI or CABG include a combined effect of surgical manipulation during operative procedure on the heart and adjacent anatomical structures, prolonged anaesthesia [29,30] and cardioplegia [10].…”

“…Studies have invariably demonstrated that coronary artery bypass grafting (CABG) also leads to significant HRV reduction [10][11][12][13]. In addition, HRV reduction after cardiac surgery is not exclusively related to PCI or CABG, as it is also recorded in patients undergoing valve surgery [14]. However, opposite conclusions still exist to show the HRV reduction after PCI is not significant [15].…”

Impact of type of intervention for aortic valve replacement on heart rate variability

“…It has been already described that the derangement of HRV after cardiac valve surgery may persist up to various months after intervention [11]. After both coronary artery by-pass surgery and valvular surgery, the greatest impairment of cardiac autonomic function and the maximal decrease of HRV parameters is reported to occur at about the sixth postoperative day, persisting rather low at 15 days after intervention [9,15], approximately the time our SAVR patients had been studied with a 24-h Holter recording.…”

“…A very limited number of papers reported that HRV decreases also in patients undergoing valvular heart surgery, and that cardiovascular autonomic dysfunction seems to be more pronounced and persisting for longer period after mitral valve surgery than aortic valve surgery [11,12].…”

Impact of cardiac surgery on the autonomic cardiovascular function

“…However, the degree of impairment can be assumed to vary with the type of intervention, i.e., which valve is concerned, and chosen operational procedure. In this regard, Lakusic et al [9] showed that the impairment in autonomic function 3.8 months after surgery was much more pronounced for mitral valve implantation compared to aortic valve implantation.…”