Effect of age on cardiac autonomic nerve function after mitral valve replacement
Objective To investigate the heart rate variability(HRV)of patients undergoing mitral valve replacement due to degener-ative mitral insufficiency in different age groups,and to evaluate the effect of age on cardiac autonomic nerve.Methods The clinical data of 391 patients admitted to General Hospital of Northern Theater Command from April 2020 to June 2023 for mitral valve replace-ment due to degenerative mitral insufficiency were retrospectively analyzed.According to the age of the patients,they were divided into group A(age 50-59,n=146),group B(age 60-69,n=196)and group C(age 70-79,n=49).The indexes of holter electrocardio-gram HRV at 7 days before and 7 days after surgery were compared in all groups,including standard deviation of NN intervals(SDANN),standard deviation of sinus heart beat RR interval(SDNN),the average of the standard deviations of NN intervals across all 5-minute segments recorded over a 24-hour period(SDNNindex),percentage of successive RR intervals that difer by more than 50 ms(PNN50),and root mean square of successive ifferences(rMSSD).Cardiac ultrasound parameters of all groups were com-pared,including left ventricular end-diastolic diameter(LVIDD),left ventricular posterior wall thickness(LVPWT),interventricular septal thickness(IVST)and left atrial diameter(LA).Results After surgery,the cardiac function index LVIDD in group A was higher than that in group B and Group C,LVPWT,IVST and LA were lower than those in group B and group C,and IVST in group B was lower than that in group C,with statistical significance(P<0.05).Before surgery,there was no statistical significance in HRV related indexes among 3 groups(P>0.05).After operation,SDNN,SDANN and SDNNindex in all groups were lower than before op-eration,and SDNN,SDANN,SDNNindex,rMSSD and PNN50 in group A were higher than those in group B and C,and all indexes in group B were higher than those in group C,with statistical significance(P<0.05).Conclusion After mitral valve replacement,with the increase of age,autonomic nervous function is impaired and cardiac reserve strength is decreased,which has an impact on postoper-ative recovery and life quality.
Heart rate variabilityAgeAfter mitral valve replacementAutonomic nerves system
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