| Long-term effects of unilateral carotid endarterectomy on arterial baroreflex function. | |
| | |
MedLine Citation:
|
PMID: 15095048 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND AND PURPOSE: Carotid endarterectomy (CE) may be complicated by the clinical syndrome of baroreflex failure. Alterations of baroreflex function may also account for the frequently observed blood pressure lability in the first hours following surgery. We investigated the long-term effects of unilateral CE on baroreflex control of function and blood pressure. METHODS: We investigated 14 patients after unilateral CE (13 m:1 f, 64.8 +/- 6.5 years), 9 patients with a surgically untreated uni-/bilateral carotid stenosis (CS, 7 m:2 f, 57.6 +/- 10.7 years) and 12 healthy controls (HC, 11 m:1 f, 60.9 +/- 7.9 years) by means of Valsalva maneuver, active standing, forced breathing, cold face test, cold pressor test and mental arithmetic. Ambulatory blood pressure level and variability were determined from 24-hour Spacelabs and 5-hour beat-to-beat Portapres recordings. RESULTS: Baroreflex sensitivity (derived from phase IV Valsalva maneuver) was significantly lower in CE (1.53 +/- 0.83 ms/mmHg) than in CS (4.39 +/- 2.27, p = 0.002) and HC (5.34 +/- 3.78, p = 0.003). CE patients exhibited a decreased reflex control of heart rate in response to Valsalva's maneuver and active standing without orthostatic hypotension. Office blood pressure levels before and after endarterectomy were similar, as were ambulatory blood pressure levels in the three groups. Ambulatory blood pressure variability was higher in CE and CS than in HC, but not different between CE and CS. CONCLUSIONS: Unilateral CE causes a long-term impairment of baroreflex function, resulting in an attenuated reflex control of heart rate, but no hypertension or blood pressure lability. |
| | |
Authors:
|
Henri J L M Timmers; Frans G M Buskens; Wouter Wieling; John M Karemaker; Jacques W M Lenders |
Related Documents
:
|
7810748 - Role of active changes in venous capacity by the carotid baroreflex: analysis with a ma... 21875118 - Temperature and volume effect on the molecular dynamics of supercooled ibuprofen at amb... 11383308 - Mechanical remodeling of small-intestine submucosa small-diameter vascular grafts--a pr... 21883958 - Effects of hyperoxic ventilation on 6-hours survival at the critical haemoglobin concen... 11897528 - The optimal pressure for initial flush with uw solution in heart procurement. 1757368 - Effects of flow on recombinant tissue plasminogen activator-induced pulmonary thromboly... |
Publication Detail:
|
Type: Clinical Trial; Controlled Clinical Trial; Journal Article |
Journal Detail:
|
Title: Clinical autonomic research : official journal of the Clinical Autonomic Research Society Volume: 14 ISSN: 0959-9851 ISO Abbreviation: Clin. Auton. Res. Publication Date: 2004 Apr |
Date Detail:
|
Created Date: 2004-04-19 Completed Date: 2004-07-06 Revised Date: 2004-11-17 |
Medline Journal Info:
|
Nlm Unique ID: 9106549 Medline TA: Clin Auton Res Country: Germany |
Other Details:
|
Languages: eng Pagination: 72-9 Citation Subset: IM |
Affiliation:
|
Dept. of General Internal Medicine, University Medical Center Nijmegen, Geert Grooteplein Zuid 8, 6500 HB Nijmegen, The Netherlands. H.Timmers@aig.umcn.nl |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adult Aged Baroreflex / physiology* Blood Pressure Carotid Stenosis / surgery* Endarterectomy, Carotid / adverse effects* Female Heart Rate Humans Male Middle Aged Postoperative Complications Time Factors |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Orthostatic tolerance in older patients with vitamin B12 deficiency before and after vitamin B12 rep...
Next Document: Adrenergic responsiveness of adipose tissue lipolysis in autonomic failure.