Document Detail


The relationship between carotid sinus hypersensitivity, orthostatic hypotension, and vasovagal syncope: a case-control study.
MedLine Citation:
PMID:  18987128     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIMS: Previous uncontrolled studies reported an overlap between carotid sinus hypersensitivity (CSH), vasovagal syncope (VVS), and orthostatic hypotension (OH). We conducted a case-control study evaluating this relationship in a large patient cohort.
METHODS AND RESULTS: The electronically stored continuous electrocardiograph and blood pressure (BP) measurements for active stand and head-up tilt-table (HUT) tests of 302 consecutive patients investigated with carotid sinus massage (CSM) were analysed. Carotid sinus hypersensitivity was defined as >or=3 s asystole and/or systolic BP (SBP) drop of >or=50 mmHg during CSM. Orthostatic hypotension was defined as BP reductions of >or=20 mmHg systolic or of >or=10 mmHg diastolic, whereas VVS was diagnosed with a positive HUT test. There was no significant difference in the number of subjects with OH (57 vs. 55%; P = 0.778) or HUT-positive VVS (45 vs. 47%; P = 0.828) between cases with CSH and controls without CSH. Carotid sinus hypersensitivity subjects had significantly larger SBP reduction (P = 0.039) and longer time to nadir (P = 0.007) during active stand, and trends to vasodepressor (P = 0.071) and dysautonomic responses to HUT (P = 0.151).
CONCLUSION: Carotid sinus hypersensitivity, OH, and VVS are common conditions affecting patients with syncope and falls which are likely to co-exist in such individuals. The differences in haemodynamic response patterns to active stand and HUT in CSH subjects could be the result of an age-associated delay in sympathetic responses.
Authors:
Maw Pin Tan; Julia L Newton; Tom J Chadwick; Steve W Parry
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2008-11-05
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:  10     ISSN:  1532-2092     ISO Abbreviation:  Europace     Publication Date:  2008 Dec 
Date Detail:
Created Date:  2008-11-21     Completed Date:  2009-02-12     Revised Date:  2013-03-06    
Medline Journal Info:
Nlm Unique ID:  100883649     Medline TA:  Europace     Country:  England    
Other Details:
Languages:  eng     Pagination:  1400-5     Citation Subset:  IM    
Affiliation:
Institute for Ageing and Health, Wolfson Centre, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, UK.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Case-Control Studies
Comorbidity
Female
Great Britain / epidemiology
Humans
Hypotension, Orthostatic / diagnosis,  epidemiology*
Incidence
Male
Middle Aged
Risk Assessment / methods*
Risk Factors
Syncope / diagnosis,  epidemiology*
Syncope, Vasovagal / diagnosis,  epidemiology*
Tilt-Table Test / statistics & numerical data
Grant Support
ID/Acronym/Agency:
RCP/DMT 1st Round (5)//The Dunhill Medical Trust

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


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