Autonomic activity and biomarker behavior in supine position and after passive postural stress in different orthostatic intolerance syndromes

Revista Portuguesa De Cardiologia : Orgão Oficial Da Sociedade Portuguesa De Cardiologia = Portuguese Journal of Cardiology : an Official Journal of the Portuguese Society of Cardiology
J FreitasFrancisco Rocha-Gonçalves

Abstract

Orthostatic intolerance (OI) syndromes are a confusing topic and determining a specific diagnosis to achieve optimal treatment can be troublesome. We sought to assess biomarker, hemodynamic and autonomic variables in OI patients (autonomic dysfunction [AD], postural orthostatic tachycardia syndrome [POTS] and neurally mediated syncope [NMS]) and healthy controls during supine and head-up tilt position in order to achieve a better diagnosis. In response to head-up tilt, patients with AD presented a marked decrease in systolic blood pressure (SBP) (p=0.002), and a blunted increase in heart rate (HR) (p=0.04). Baroreceptor gain was almost absent in supine position and did not change in response to tilt. Patients with POTS had lower values of atrial natriuretic peptide (p=0.03) but similar neurohormonal biomarkers and hemodynamic and baroreceptor function in supine position compared to healthy subjects. However, in response to head-up tilting greater reductions in stroke volume (p=0.008) and baroreceptor gain (p=0.002) and greater rises in HR (p=0.001), total peripheral resistance (p=0.008), low frequency component of SBP variability (LF-SBP) (p=0.003) and plasma noradrenaline (p=0.03) were observed. Patients with NCS had similar b...Continue Reading

References

Feb 28, 2001·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·J FreitasA Falcão de Freitas
Jul 14, 2007·Journal of Applied Physiology·Shizue MasukiMichael J Joyner
Dec 20, 2007·Cardiology in Review·Marvin S MedowWilliam H Frishman
Feb 12, 2009·Journal of Cardiovascular Electrophysiology·Phillip A LowWin-Kuang Shen

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Citations

Feb 9, 2017·Clinical Autonomic Research : Official Journal of the Clinical Autonomic Research Society·Cathy L Pederson, Jill Blettner Brook
Jul 1, 2016·Porto Biomedical Journal·Mariana SilvaJoão Freitas

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