Document Detail


Carotid sinus hypersensitivity: disease state or clinical sign of ageing? Insights from a controlled study of autonomic function in symptomatic and asymptomatic subjects.
MedLine Citation:
PMID:  20823040     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIMS: This study sought to improve the currently limited understanding of the pathophysiology of carotid sinus hypersensitivity (CSH) by comparing autonomic function measured by heart rate variability (HRV) and baroreflex sensitivity inpatients with symptomatic CSH and asymptomatic individuals with and without CSH.
METHODS AND RESULTS: Twenty-two patients with symptomatic CSH, 18 individuals with asymptomatic CSH, and 14 asymptomatic older individuals without CSH were recruited to our study. Non-invasive measurements of heart rate and blood pressure were obtained during 10 min of supine rest. Low frequency (LF), high frequency (HF), and total power spectral density (PSD) for HRV were determined using the autoregressive method. The baroreflex slope (BRS) and baroreflex effectiveness index (BEI) were determined using the sequence method for baroreflex sensitivity. There were significant increases in the LF-HRV (P = 0.014), total PSD (P = 0.031), LF:HF (P = 0.047), normalized (nu) LF-HRV (0.049), down ramp BEI (P = 0.017), and total BEI (P = 0.038) in the symptomatic CSH group compared with non-CSH controls. The asymptomatic CSH group had significantly higher LF-HRV (P = 0.001), total PSD (P = 0.002), nuLF-HRV (P = 0.026), and LF:HF (P = 0.030), as well as up, down, and total BRS (P = 0.012, P = 0.015, and P = 0.011, respectively) and BEI (P = 0.049, P = 0.001, and P = 0.006, respectively) than non-CSH control participants.
CONCLUSION: This study has demonstrated an association between CSH with increased resting sympathetic activity and baroreflex sensitivity regardless of the presence of symptoms, indicating the presence of autonomic dysregulation in individuals with CSH. Our findings therefore suggest that CSH is part of a generalized autonomic disorder but do not differentiate between asymptomatic and symptomatic individuals.
Authors:
Maw Pin Tan; Rose Anne M Kenny; Tom J Chadwick; Simon R J Kerr; Steve W Parry
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-09-07
Journal Detail:
Title:  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     Volume:  12     ISSN:  1532-2092     ISO Abbreviation:  Europace     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-10-26     Completed Date:  2011-02-16     Revised Date:  2013-03-06    
Medline Journal Info:
Nlm Unique ID:  100883649     Medline TA:  Europace     Country:  England    
Other Details:
Languages:  eng     Pagination:  1630-6     Citation Subset:  IM    
Affiliation:
Institute for Ageing and Health, Newcastle University, Newcastle upon Tyne, UK.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aging / physiology*
Autonomic Nervous System / physiopathology*
Autonomic Nervous System Diseases / physiopathology*
Baroreflex / physiology
Blood Pressure / physiology
Carotid Sinus / innervation*,  physiopathology*
Cohort Studies
Female
Heart / physiopathology
Heart Rate / physiology
Humans
Male
Supine Position / physiology
Syncope / physiopathology
Grant Support
ID/Acronym/Agency:
RCP/DMT 1st Round (5)//The Dunhill Medical Trust
Comments/Corrections
Comment In:
Europace. 2010 Nov;12(11):1516-7   [PMID:  20974764 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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