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Blood pressure overshoot after tilt reversal in patients with familial amyloidotic polyneuropathy.
MedLine Citation:
PMID:  20927118     Owner:  NLM     Status:  In-Process    
The pathophysiology of the hemodynamic responses to postural stress in familial amyloidotic polyneuropathy (FAP) remains to be elucidated. The aim of the study was to evaluate hemodynamic responses after tilt reversal in FAP. Systolic blood pressure (BP) and heart rate variability (HRV) were analyzed in the baseline, 70° upright position, and after tilt reversal in 15 FAP patients and 14 healthy controls. Beat-to-beat BP was recorded with a Finapres device. Maximum systolic BP after tilt reversal was increased with 22 ± 13 mm Hg in FAP patients as compared with baseline (BP overshoot), whereas controls showed a significantly lower BP overshoot (8 ± 6 mm Hg, P < 0.001). In all states, total spectral power and the power of the low and high frequency components were all significantly lower than those of the controls (P < 0.01). In a linear regression analysis adjusted for age, we found a significant inverse relation between BP overshoot and HRV (total spectral power, power of the low-frequency and high-frequency components) in all three states (standardized β between -0.74 to -0.53, P < 0.01). Five FAP patients presented a trial arrhythmia precluding HRV analysis: four of those presented BP overshoots ≥ 12 mm Hg. BP overshoot may be a marker to assess the progression of cardiac autonomic dysfunction, especially as heart arrhythmia in many FAP patients prevent HRV analysis. In addition, assessment of the post-tilt BP reaction points to possible treatment modalities for orthostatic hypotension at least in the early stages of the disease.
Konen Obayashi; Rolf Hörnsten; Urban Wiklund; Marcus Karlsson; Sadahisa Okamoto; Yukio Ando; Ole B Suhr
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-10-07
Journal Detail:
Title:  Hypertension research : official journal of the Japanese Society of Hypertension     Volume:  34     ISSN:  1348-4214     ISO Abbreviation:  Hypertens. Res.     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2011-01-05     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9307690     Medline TA:  Hypertens Res     Country:  England    
Other Details:
Languages:  eng     Pagination:  133-8     Citation Subset:  IM    
Department of Medicine, Umeå University Hospital, Umeå, Sweden.
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