The association between perception of noise from a mechanical heart valve and symptoms of anxiety and depression.

Aims: Patients with symptomatic aortic valve stenosis are efficiently treated by aortic valve replacement (AVR), using a biological or mechanical valve. For some patients with mechanical valves, the metallic clicking sound may be problematic. The aim of this study was to investigate the perceived disturbance from the sound of a mechanical valve and the association between noise perception and symptoms of anxiety and depression.

Methods and results: The study had a cross-sectional design. In April 2013, all patients who had undergone AVR at one university hospital during the period 2000-12 were invited by post to participate. The primary variables were assessed using a valve-specific questionnaire and the Hospital Anxiety and Depression Scale. Of the 912 (77%) respondents, 245 had mechanical valves. Of these, 59 (24%) were women, the mean (standard deviation) age was 61 (11) years, and the mean time since surgery was 7 (3) years. The valve-specific questionnaire showed that 84% of the patients could sometimes or often hear the valve sound. A moderate positive correlation was found between valve prosthesis noise disturbance and anxiety, r = 0.35 (P = 0.001), and depression, r = 0.27 (P = 0.001). In a multiple linear regression analysis, valve noise perception was only significantly associated with anxiety among several other bio-psychosocial factors.

Conclusion: This study shows an association between valve noise disturbance and symptoms of anxiety and highlights the importance of preparing all patients for the sound from the mechanical valves that arises after surgery.