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Titolo:
Cerebral autoregulatory responses to head-up tilt in normal subjects and patients with recurrent vasovagal syncope
Autore:
Carey, BJ; Manktelow, BN; Panerai, RB; Potter, JF;
Indirizzi:
Univ Leicester, Glenfield Hosp, Div Med Elderly, Leicester LE3 9QP, Leics,England Univ Leicester Leicester Leics England LE3 9QP ter LE3 9QP, Leics,England Univ Leicester, Leicester Royal Infirm, Div Med Phys, Leicester LE1 7RH, Leics, England Univ Leicester Leicester Leics England LE1 7RH er LE1 7RH, Leics, England Univ Leicester, Dept Epidemiol, Leicester LE1 7RH, Leics, England Univ Leicester Leicester Leics England LE1 7RH er LE1 7RH, Leics, England
Titolo Testata:
CIRCULATION
fascicolo: 8, volume: 104, anno: 2001,
pagine: 898 - 902
SICI:
0009-7322(20010821)104:8<898:CARTHT>2.0.ZU;2-T
Fonte:
ISI
Lingua:
ENG
Soggetto:
BLOOD-PRESSURE; UPRIGHT TILT; ORTHOSTATIC STRESS; FREQUENCY-DOMAIN; CARBON-DIOXIDE; FLOW VELOCITY; ARTERIAL; HUMANS;
Keywords:
syncope; cerebrovascular circulation; ultrasonics;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
32
Recensione:
Indirizzi per estratti:
Indirizzo: Carey, BJ Univ Leicester, Glenfield Hosp, Div Med Elderly, Groby Rd, Leicester LE3 9QP, Leics, England Univ Leicester Groby Rd Leicester Leics England LE3 9QP England
Citazione:
B.J. Carey et al., "Cerebral autoregulatory responses to head-up tilt in normal subjects and patients with recurrent vasovagal syncope", CIRCULATION, 104(8), 2001, pp. 898-902

Abstract

Background-The effect of orthostatic stress on dynamic cerebral autoregulation (CA) in normal subjects and patients with recurrent vasovagal syncope (VVS) is unclear. This study assessed the dynamic CA responses of both groups to head-up tilt. Methods and Results-Seventeen patients with recurrent VVS and 17 pair-matched control subjects underwent 70 degrees head-up tilt for up to 30 minutes. Bilateral middle cerebral artery blood flow velocities (CBFV) were measured with transcranial Doppler ultrasound along with noninvasive beat-to-beatblood pressure (BP), heart rate, and transcutaneous and end-tidal CO2 concentrations. Indices of dynamic CA were derived for periods before, during, and after tilt. Eight normal subjects who developed VVS in an identical protocol but who had no previous clinical history of syncope were also studied. CBFV and transcutaneous and end-tidal CO2 levels declined significantly during head-up tilt in all groups (P < 0.0001). Dynamic CA indices were unchanged throughout tilt in nonsyncopal control subjects and were initially unchanged in patients but deteriorated significantly in patients and syncopalcontrol subjects in the minutes before (P = 0.027 and P = 0.012, respectively) and after (P = 0.002 and P = 0.007, respectively) syncope. Conclusions-Dynamic CA is preserved in patients and control subjects initially after head-up tilt. Autoregulatory function remains intact in nonsyncopal control subjects during prolonged orthostasis but deteriorates in patients and syncopal control subjects immediately before and after VVS.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 28/11/20 alle ore 04:13:00