| Effect of cough on heart rate and blood pressure in patients with "cough syncope". | |
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MedLine Citation:
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PMID: 16051114 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: "Cough syncope" is uncommon, and its mechanism remains controversial. OBJECTIVES: This study evaluated susceptibility to cough-triggered neural reflex hypotension-bradycardia among cough syncope patients. We hypothesized that individuals with cough syncope would manifest not only more profound cough-triggered hypotension than do other fainters but also an inappropriate chronotropic response accompanying cough-induced hypotension, thereby supporting the notion that a neural reflex hypotension-bradycardia contributes to the condition. METHODS/RESULTS: Three patient groups were studied. Group 1 patients (n = 9) had "cough syncope." The remaining patients had recurrent faints of other causes: group 2 (n = 13) had a positive head-up tilt test, and group 3 (n = 18) had a negative tilt test. With cough, group 1 patients exhibited a greater drop in systolic pressure (-51 +/- 19.3 mmHg) than did either group 2 (-23 +/- 11.1 mmHg, P < .04) or group 3 patients (-28 +/- 12.4 mmHg, P < .05). Recovery time to normalization of systolic pressure was greater in group 1 (25 +/- 9.1 seconds) than in group 2 or 3 (8 +/- 2.7 seconds and 9 +/- 6.1 seconds, respectively, both P < .01 vs group 1). The expected positive chronotropic response accompanying cough-induced hypotension was diminished in group 1 patients (0.16 +/- 0.21 bpm/mmHg) compared with that in either group 2 (0.74 +/- 0.60 bpm/mmHg, P < .05 vs group 1) or group 3 (0.33 +/- 0.15 bpm/mmHg, P = .06 vs group 1). CONCLUSION: Cough syncope patients not only exhibit more pronounced hypotension in response to cough than other fainters, but they also manifest an inappropriate cough-triggered blood pressure-heart rate relationship. These findings argue in favor of the importance of a neurally mediated reflex contribution to symptomatic hypotension in cough syncope. |
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Authors:
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David G Benditt; Nemer Samniah; Scott Pham; Scott Sakaguchi; Fei Lu; Keith G Lurie; Cengiz Ermis |
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Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Heart rhythm : the official journal of the Heart Rhythm Society Volume: 2 ISSN: 1547-5271 ISO Abbreviation: Heart Rhythm Publication Date: 2005 Aug |
Date Detail:
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Created Date: 2005-07-29 Completed Date: 2005-12-28 Revised Date: 2009-10-27 |
Medline Journal Info:
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Nlm Unique ID: 101200317 Medline TA: Heart Rhythm Country: United States |
Other Details:
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Languages: eng Pagination: 807-13 Citation Subset: IM |
Affiliation:
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Cardiac Arrhythmia Center, Department of Medicine, Cardiovascular Division, University of Minnesota Medical School, Minneapolis, Minnesota, USA. bendi001@umn.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Aged, 80 and over Blood Pressure* Bradycardia / etiology Cough / complications* Disease Susceptibility Electrocardiography Female Heart Rate* Humans Hypotension / etiology Male Middle Aged Syncope / etiology, physiopathology* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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