| Norepinephrine transporter inhibition prevents tilt-induced pre-syncope. | |
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MedLine Citation:
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PMID: 16875978 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: We tested the hypothesis that pharmacological norepinephrine reuptake transporter (NET) inhibition delays the onset of head-up tilt-induced presyncope in healthy subjects. BACKGROUND: Treatment of neurally mediated syncope is unsatisfactory. In a previous study in a small number of healthy subjects, pharmacologic NET inhibition delayed the onset of head-up tilt-induced pre-syncope. METHODS: We combined data sets from 3 substudies comprising 51 healthy subjects without a history of syncope. In a double-blind, randomized, cross-over fashion, subjects underwent 2 head-up tilt tests, once with placebo and once with a NET inhibitor (sibutramine or reboxetine). Tilt testing was prematurely ended when pre-syncopal symptoms such as dizziness, nausea, or visual disturbances occurred together with a decrease in blood pressure and/or heart rate. RESULTS: The mean tolerated tilt test duration was 29 +/- 2 min with placebo and 35 +/- 1 min with NET inhibition (p = 0.001). The odds ratio for premature abortion of head-up tilt testing was 0.22 (95% confidence interval 0.09 to 0.55, p < 0.001) in favor of NET inhibition. Norepinephrine reuptake transporter inhibition elicited a pressor response and increased upright heart rate. CONCLUSIONS: In healthy subjects, NET inhibition prevents tilt-induced neurally mediated (pre)syncope. Therefore, NET inhibition may be a worthwhile target of drug intervention for larger trials in highly symptomatic patients with neurally mediated syncope. |
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Authors:
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Christoph Schroeder; Andreas L Birkenfeld; Antje F Mayer; Jens Tank; Andre Diedrich; Friedrich C Luft; Jens Jordan |
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Publication Detail:
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Type: Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't Date: 2006-07-12 |
Journal Detail:
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Title: Journal of the American College of Cardiology Volume: 48 ISSN: 1558-3597 ISO Abbreviation: J. Am. Coll. Cardiol. Publication Date: 2006 Aug |
Date Detail:
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Created Date: 2006-07-31 Completed Date: 2006-08-16 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8301365 Medline TA: J Am Coll Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 516-22 Citation Subset: AIM; IM |
Affiliation:
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Franz-Volhard Clinical Research Center, Medical Faculty of the Charité and HELIOS Klinikum, Berlin, Germany. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Blood Pressure
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drug effects Cross-Over Studies Cyclobutanes / therapeutic use* Double-Blind Method Head-Down Tilt Heart Rate / drug effects Humans Morpholines / therapeutic use* Norepinephrine Plasma Membrane Transport Proteins / antagonists & inhibitors* Posture* Syncope / etiology*, prevention & control* |
| Chemical | |
Reg. No./Substance:
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0/Cyclobutanes; 0/Morpholines; 0/Norepinephrine Plasma Membrane Transport Proteins; 106650-56-0/sibutramine; 98769-81-4/reboxetine |
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