Document Detail


Effect of cough on heart rate and blood pressure in patients with "cough syncope".
MedLine Citation:
PMID:  16051114     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
David G Benditt; Nemer Samniah; Scott Pham; Scott Sakaguchi; Fei Lu; Keith G Lurie; Cengiz Ermis
Related Documents :
14640094 - Effects of depressed myocardial contractility induced by microgravity on cardiovascular...
11540684 - Effects of a gravity gradient on human cardiovascular responses.
7033504 - The effect of vagotomy on sodium reabsorption and renin release in anaesthetized dogs s...
11788414 - Hypovolemia and neurovascular control during orthostatic stress.
12541224 - Mr findings of collateral circulation are more accurate measures of hemodynamic signifi...
24492424 - Home blood pressure monitoring in heart transplant recipients: comparison with ambulato...
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
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:
Created Date:  2005-07-29     Completed Date:  2005-12-28     Revised Date:  2009-10-27    
Medline Journal Info:
Nlm Unique ID:  101200317     Medline TA:  Heart Rhythm     Country:  United States    
Other Details:
Languages:  eng     Pagination:  807-13     Citation Subset:  IM    
Affiliation:
Cardiac Arrhythmia Center, Department of Medicine, Cardiovascular Division, University of Minnesota Medical School, Minneapolis, Minnesota, USA. bendi001@umn.edu
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
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


Previous Document:  Phase 2 reentry in man.
Next Document:  Cardioverter-defibrillator implantation in high-risk patients with hypertrophic cardiomyopathy.