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[PMID]:27773421
[Au] Autor:Posey JE; Martinez R; Lankford JE; Lupski JR; Numan MT; Butler IJ
[Ad] Endereço:Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas. Electronic address: Jennifer.Posey@bcm.edu.
[Ti] Título:Dominant Transmission Observed in Adolescents and Families With Orthostatic Intolerance.
[So] Source:Pediatr Neurol;66:53-58.e5, 2017 Jan.
[Is] ISSN:1873-5150
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Orthostatic intolerance is typically thought to be sporadic and attributed to cerebral autonomic dysfunction. We sought to identify families with inherited autonomic dysfunction manifest as symptomatic orthostatic intolerance to characterize mode of inheritance and clinical features. METHODS: Sixteen families with two or more first- or second-degree relatives with autonomic dysfunction and orthostatic intolerance were enrolled. A clinical diagnosis of autonomic dysfunction defined by symptomatic orthostatic intolerance diagnosed by head-up tilt table testing was confirmed for each proband. Clinical features and evaluation were obtained from each proband using a standardized intake questionnaire, and family history information was obtained from probands and available relatives. RESULTS: Comprehensive pedigree analysis of 16 families (39 individuals with orthostatic intolerance and 40 individuals suspected of having orthostatic intolerance) demonstrated dominant transmission of autonomic dysfunction with incomplete penetrance. Affected individuals were predominantly female (71.8%, 28/39; F:M, 2.5:1). Male-to-male transmission, although less common, was observed and demonstrated to transmit through unaffected males with an affected parent. Similar to sporadic orthostatic intolerance, probands report a range of symptoms across multiple organ systems, with headaches and neuromuscular features being most common. CONCLUSIONS: Familial occurrence and vertical transmission of autonomic dysfunction in 16 families suggest a novel genetic syndrome with dominant transmission, incomplete penetrance, and skewing of the sex ratio. Elucidation of potential genetic contributions to orthostatic intolerance may inform therapeutic management and identification of individuals at risk. Adolescent evaluation should include identification and treatment of potential at-risk relatives.
[Mh] Termos MeSH primário: Família
Testes Genéticos
Intolerância Ortostática/fisiopatologia
[Mh] Termos MeSH secundário: Adolescente
Estudos de Coortes
Feminino
Seres Humanos
Masculino
Intolerância Ortostática/diagnóstico
Intolerância Ortostática/genética
Linhagem
Postura/fisiologia
Inquéritos e Questionários
Teste da Mesa Inclinada
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:180101
[Lr] Data última revisão:
180101
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161025
[St] Status:MEDLINE


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[PMID]:28862519
[Au] Autor:Uchino H; Kazumata K; Ito M; Nakayama N; Houkin K
[Ad] Endereço:Department of Neurosurgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
[Ti] Título:Novel insights into symptomatology of moyamoya disease in pediatric patients: survey of symptoms suggestive of orthostatic intolerance.
[So] Source:J Neurosurg Pediatr;20(5):485-488, 2017 Nov.
[Is] ISSN:1933-0715
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE A specific population of young patients with moyamoya disease (MMD) persistently experience physical symptoms not attributable to focal ischemia. These symptoms, highly suggestive of orthostatic intolerance (also termed "orthostatic dysregulation"), were investigated and reported as potential determinants of quality of life in young MMD patients. METHODS Forty-six patients (6-30 years of age) were selected from a group of 122 patients who were diagnosed with MMD before 18 years of age. The authors administered a structured questionnaire consisting of 11 items based on screening checklists published in the Japanese clinical guidelines for juvenile orthostatic dysregulation in young patients. The results were tabulated, and correlations with clinical data were explored. RESULTS Thirty-seven (80%) patients (mean age 15.9 years) responded to the questionnaire. Frequent headache, vertigo/dizziness on standing, fatigue, difficulty with getting out of bed, and motion sickness were the top 5 symptoms, resulting in 57% of patients being unable to attend school. Forty-three percent of the patients demonstrated multiple symptoms suggestive of orthostatic intolerance, even as long as 5 years after revascularization surgery. The number of symptoms was inversely associated with the number of years after surgery (p = 0.028). The number of symptoms was not associated with a history of surgery, clinical presentations, vascular involvement, cerebral perfusion, brain lesions, or history of transient ischemic attacks. CONCLUSIONS The present study provided novel insight into the symptomatology of young patients with MMD. Failure to notice nonfocal physical symptoms can significantly impair quality of life in young patients with MMD even years after successful revascularization surgery. These symptoms may serve as independent clinical markers used to assess disease outcome, although the underlying mechanisms of this disease are, as of yet, unclear.
[Mh] Termos MeSH primário: Doença de Moyamoya/fisiopatologia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Criança
Feminino
Seres Humanos
Modelos Lineares
Masculino
Doença de Moyamoya/diagnóstico por imagem
Doença de Moyamoya/epidemiologia
Doença de Moyamoya/cirurgia
Análise Multivariada
Intolerância Ortostática/fisiopatologia
Prevalência
Estudos Prospectivos
Inquéritos e Questionários
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171102
[Lr] Data última revisão:
171102
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170902
[St] Status:MEDLINE
[do] DOI:10.3171/2017.5.PEDS17198


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[PMID]:28818139
[Au] Autor:Paloski WH; Reschke MF; Feiveson AH
[Ti] Título:Bed Rest and Intermittent Centrifugation Effects on Human Balance and Neuromotor Reflexes.
[So] Source:Aerosp Med Hum Perform;88(9):812-818, 2017 Sep 01.
[Is] ISSN:2375-6314
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: The effects of repeated centrifugation in association with head-down tilt (HDT) bed rest (BR) on the mediation of basic reflexes associated with the major postural muscles was investigated as a potential countermeasure for maintaining balance control and neuromotor reflex function. METHODS: There were 15 male volunteers who were exposed to 21 d of 6° HDT-BR. Eight were treated with daily 1-h artificial gravity (AG) exposures aboard a short radius centrifuge that provided 1-g footward loading at heart level. The other seven served as HDT-BR control subjects. Balance control was assessed using a standard computerized dynamic posturography (CDP) protocol that was modified by adding low-frequency pitch-plane head movements. Neuromotor reflex function was assessed using tendon stretch reflexes (MSR) and functional stretch reflex (FSR) data collected from the triceps surae muscle group. RESULTS: CDP performance was degraded by HDT-BR in both groups (ranging from 24 to 26%), but was unaffected by AG. BR also degraded MSR and FSR functions in both groups, with increased peak reflex latencies between 1.5 and 1.95 ms, but AG maintained pre-BR latencies for the MSR subjects. DISCUSSION: AG exposure did not modify balance control from pre-BR responses, but did help prevent decrements in FSR latencies post-BR.Paloski WH, Reschke MF, Feiveson AH. Bed rest and intermittent centrifugation effects on human balance and neuromotor reflexes. Aerosp Med Hum Perform. 2017; 88(9):812-818.
[Mh] Termos MeSH primário: Repouso em Cama
Gravidade Alterada
Decúbito Inclinado com Rebaixamento da Cabeça/fisiologia
Intolerância Ortostática/fisiopatologia
Equilíbrio Postural/fisiologia
Reflexo de Estiramento/fisiologia
[Mh] Termos MeSH secundário: Adaptação Fisiológica
Adulto
Voluntários Saudáveis
Seres Humanos
Masculino
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171010
[Lr] Data última revisão:
171010
[Sb] Subgrupo de revista:IM; S
[Da] Data de entrada para processamento:170819
[St] Status:MEDLINE
[do] DOI:10.3357/AMHP.4819.2017


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[PMID]:28738696
[Au] Autor:Ruzieh M; Batizy L; Dasa O; Oostra C; Grubb B
[Ad] Endereço:a Department of Internal Medicine , University of Toledo , Toledo , OH , USA.
[Ti] Título:The role of autoantibodies in the syndromes of orthostatic intolerance: a systematic review.
[So] Source:Scand Cardiovasc J;51(5):243-247, 2017 Oct.
[Is] ISSN:1651-2006
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Orthostatic intolerance is defined as the provocation of symptoms upon standing, commonly caused by neurogenic orthostatic hypotension (OH) and postural tachycardia syndrome (POTS), the etiology for which has not been fully uncovered yet. Many reports have described the occurrence of dysautonomia, orthostatic intolerance and POTS following febrile illness, presumably viral and post-vaccine. Furthermore, patients with dysautonomia have higher rates of autoimmune disorders such as Hashimoto thyroiditis and SLE. Recent evidence has shown the presence of adrenergic and cholinergic receptor antibodies in patients with POTS and orthostatic hypotension. In patients with cholinergic receptor antibodies, higher titers correlate with the disease severity. Few reports have shown that immunomodulation therapy resulted in significant improvement in symptoms. In this article, we review the available literature correlating autoimmunity with orthostatic intolerance syndromes. Future studies are warranted to evaluate the prevalence of such antibodies and examine different treatment modalities in this sub group of patients.
[Mh] Termos MeSH primário: Autoanticorpos/imunologia
Autoimunidade
Pressão Sanguínea
Intolerância Ortostática/imunologia
Postura
Receptores Adrenérgicos/imunologia
Receptores Colinérgicos/imunologia
[Mh] Termos MeSH secundário: Animais
Seres Humanos
Intolerância Ortostática/fisiopatologia
Fatores de Risco
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Autoantibodies); 0 (Receptors, Adrenergic); 0 (Receptors, Cholinergic)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170918
[Lr] Data última revisão:
170918
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170726
[St] Status:MEDLINE
[do] DOI:10.1080/14017431.2017.1355068


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[PMID]:28591231
[Au] Autor:Sunwoo JS; Yang TW; Kim DY; Lim JA; Kim TJ; Byun JI; Moon J; Lee ST; Jung KH; Park KI; Jung KY; Kim M; Lee SK; Chu K
[Ad] Endereço:Department of Neurology, Soonchunhyang University College of Medicine, Seoul, South Korea.
[Ti] Título:Association of blood pressure variability with orthostatic intolerance symptoms.
[So] Source:PLoS One;12(6):e0179132, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The short-term blood pressure variability (BPV) reflects autonomic regulatory mechanisms. However, the influence of BPV in orthostatic intolerance (OI) is unknown. Herein, we assessed BPV profiles in patients with OI and determined their association with orthostatic symptoms. In this cross-sectional study, we prospectively enrolled 126 patients presenting with OI at the Seoul National University Hospital from December 2014 to August 2016. Among them, those with other neurological diseases (n = 8) and insufficient BP measurements (n = 15) were excluded. The degree of OI symptoms were measured using the self-administered orthostatic intolerance questionnaire (OIQ). All patients underwent ambulatory BP monitoring and we calculated the standard deviation and coefficient of variation as a measure of BPV. The mean age was 48.6 years and the average of the total OIQ score was 11.6. The severe OI group had higher BPV values than the mild group, although mean BP profiles did not differ significantly. Correlation analysis demonstrated that the orthostatic symptoms were positively correlated with diastolic BPV for the total and awake periods. Multiple linear regression analysis revealed that diastolic BPV (B = 0.46, p = 0.031) and current smoking (B = 4.687, p = 0.018) were independent factors for higher OI symptom scores after adjusting for covariates. The results of the current study demonstrated that a positive correlation exists between BPV and OI symptoms. Further studies are required to confirm the present findings and understand the neural mechanisms contributing to the excessive BPV in patients with OI.
[Mh] Termos MeSH primário: Pressão Sanguínea/fisiologia
Frequência Cardíaca/fisiologia
Intolerância Ortostática/epidemiologia
Intolerância Ortostática/fisiopatologia
[Mh] Termos MeSH secundário: Adulto
Idoso
Monitorização Ambulatorial da Pressão Arterial
Estudos Transversais
Feminino
Seres Humanos
Masculino
Meia-Idade
Intolerância Ortostática/complicações
Seul
Inquéritos e Questionários
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170913
[Lr] Data última revisão:
170913
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170608
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0179132


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[PMID]:28383399
[Au] Autor:Rodriguez J; Blaber AP; Kneihsl M; Trozic I; Ruedl R; Green DA; Broadbent J; Xu D; Rössler A; Hinghofer-Szalkay H; Fazekas F; Goswami N
[Ad] Endereço:aGravitational Physiology and Medicine Research Unit, Institute of Physiology, Medical University of Graz, Graz, Austria bCentre of Human and Aerospace Physiological Sciences, King's College London, London, UK cAerospace Physiology Laboratory, Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, Canada dDepartment of Neurology, Medical University of Graz, Graz, Austria eCentre of Human and Aerospace Physiological Sciences (CHAPS), King's College London, Faculty of Life Sciences and Medicine, Guy's Campus, London, UK fKBRwyle, European Astronaut Centre, Linder Höhe, Cologne, Germany.
[Ti] Título:Poststroke alterations in heart rate variability during orthostatic challenge.
[So] Source:Medicine (Baltimore);96(14):e5989, 2017 Apr.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Older adults following recovery from ischemic stroke have a higher incidence of orthostatic hypotension, syncope, and fall risk, which may be related to impaired autonomic responses limiting the ability to maintain cerebral blood flow. Thus, we investigated cerebrovascular and cardiovascular regulation in 23 adults ≥55 years of age, 10 diagnosed with ischemic stroke, and 13 age-matched healthy controls when sitting at rest and upon standing to compare differences of autonomic variables at ∼7 months (218 ±â€Š41 days) poststroke.Arterial blood pressure via finger plethysmography, muscle-pump baroreflex via electromyography, heart rate variability via 3-lead ECG, and cerebral blood flow velocity via transcranial Doppler were analyzed while sitting for 5 minutes and then during quiet standing for 5 minutes.From the seated to standing position, the stroke group had significantly greater decline in the low frequency component of heart rate variability (164 [79] vs 25 [162] ms; P = 0.043). All other cardiovascular parameters and assessments of autonomic function were not significantly different between the two groups.Our findings support the hypothesis of continued autonomic dysfunction after recovery from ischemic stroke, with potential attenuation of the cardiovascular response to standing. However, further investigation is required to determine the mechanisms underlying the increased risk of orthostatic hypotension, syncope, and falls poststroke.
[Mh] Termos MeSH primário: Pressão Sanguínea
Frequência Cardíaca
Acidente Vascular Cerebral/fisiopatologia
[Mh] Termos MeSH secundário: Idoso
Estudos de Casos e Controles
Feminino
Seres Humanos
Masculino
Meia-Idade
Intolerância Ortostática
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170503
[Lr] Data última revisão:
170503
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170407
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000005989


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[PMID]:28351846
[Au] Autor:Medow MS; Merchant S; Suggs M; Terilli C; O'Donnell-Smith B; Stewart JM
[Ad] Endereço:Departments of Pediatrics, and marvin_medow@nymc.edu.
[Ti] Título:Postural Heart Rate Changes in Young Patients With Vasovagal Syncope.
[So] Source:Pediatrics;139(4), 2017 Apr.
[Is] ISSN:1098-4275
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND AND OBJECTIVES: Recurrent postural vasovagal syncope (VVS) is caused by transient cerebral hypoperfusion from episodic hypotension and bradycardia; diagnosis is made by medical history. VVS contrasts with postural tachycardia syndrome (POTS), defined by chronic daily symptoms of orthostatic intolerance with excessive upright tachycardia without hypotension. POTS has recently been conflated with VVS when excessive tachycardia is succeeded by hypotension during tilt testing. We hypothesize that excessive tachycardia preceding hypotension and bradycardia is part of the vasovagal response during tilt testing of patients with VVS. METHODS: We prospectively performed head-up tilt (HUT) testing on patients with recurrent VVS ( = 47, 17.9 ± 1.1 y), who fainted at least 3 times within the last year, and control subjects ( = 15, 17.1 ± 1.0 y), from age and BMI-matched volunteers and measured blood pressure, heart rate (HR), cardiac output, total peripheral resistance, and end tidal carbon dioxide. RESULTS: Baseline parameters were the same in both groups. HR (supine versus 5 and 10 minutes HUT) significantly increased in control (65 ± 2.6 vs 83 ± 3.6 vs 85 ± 3.7, < .001) and patients with VVS (69 ± 1.6 vs 103 ± 2.3 vs 109 ± 2.4, < .001). HUT in controls maximally increased HR by 20.3 ± 2.9 beats per minute; the increase in patients with VVS of 39.8 ± 2.1 beats per minute was significantly greater ( < .001). An increase in HR of ≥40 beats per minute by 5 and 10 minutes or before faint with HUT, occurred in 26% and 44% of patients with VVS, respectively, but not in controls. CONCLUSIONS: Orthostasis in VVS is accompanied by large increases in HR that should not be construed as POTS.
[Mh] Termos MeSH primário: Frequência Cardíaca/fisiologia
Intolerância Ortostática/diagnóstico
Síncope Vasovagal/diagnóstico
[Mh] Termos MeSH secundário: Adolescente
Pressão Sanguínea/fisiologia
Criança
Feminino
Seres Humanos
Masculino
Estudos Prospectivos
Teste da Mesa Inclinada
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:171110
[Lr] Data última revisão:
171110
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170330
[St] Status:MEDLINE


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[PMID]:28112481
[Au] Autor:Christou GA; Kiortsis DN
[Ad] Endereço:Laboratory of Physiology, Medical School, University of Ioannina, Ioannina, Greece.
[Ti] Título:The effects of body weight status on orthostatic intolerance and predisposition to noncardiac syncope.
[So] Source:Obes Rev;18(3):370-379, 2017 Mar.
[Is] ISSN:1467-789X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Orthostatic intolerance (OI) is frequently the mechanism underlying the occurrence of noncardiac syncope (NCS) and is associated with substantial risk for injury. Body weight status appears to be a modifier of orthostatic responses and possibly influences the propensity to NCS. The majority of cross-sectional studies have found that the lower the body mass index (BMI) the greater the predisposition to OI is, accompanied with both down-regulation of sympathetic nervous system activity and up-regulation of parasympathetic nervous system activity. These changes appear to occur across the whole spectrum of BMI values from underweight to obesity, while they may be associated more strongly with central body fat than total body fat. Weight loss following bariatric surgery has been consistently found to increase OI, attributed first to the effects of weight loss per se, second to the specific type of surgical procedure and third to the potential postoperative autonomic neuropathy due to vitamin deficiency. The increased OI following bariatric surgery renders this intervention not easily tolerable for the affected individuals, mandating increased fluid and salt intake, pharmacological measures or surgical adjustments to attenuate OI. All future studies investigating orthostatic responses and NCS should implement a matching of the population arms for BMI and ideally for body fat.
[Mh] Termos MeSH primário: Índice de Massa Corporal
Intolerância Ortostática/fisiopatologia
Síncope/fisiopatologia
Perda de Peso
[Mh] Termos MeSH secundário: Adiposidade
Cirurgia Bariátrica
Suscetibilidade a Doenças
Seres Humanos
Obesidade/dietoterapia
Obesidade/cirurgia
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171011
[Lr] Data última revisão:
171011
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170124
[St] Status:MEDLINE
[do] DOI:10.1111/obr.12501


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[PMID]:27638295
[Au] Autor:Jans Ø; Kehlet H
[Ad] Endereço:Section of Surgical Pathophysiology 4074, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark.
[Ti] Título:Postoperative orthostatic intolerance: a common perioperative problem with few available solutions.
[Ti] Título:L'intolérance orthostatique postopératoire: malgré un problème périopératoire fréquent, peu de solutions..
[So] Source:Can J Anaesth;64(1):10-15, 2017 Jan.
[Is] ISSN:1496-8975
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Intolerância Ortostática/terapia
Período Perioperatório
Complicações Pós-Operatórias/terapia
[Mh] Termos MeSH secundário: Seres Humanos
Intolerância Ortostática/epidemiologia
Intolerância Ortostática/prevenção & controle
Complicações Pós-Operatórias/fisiopatologia
Prevalência
[Pt] Tipo de publicação:EDITORIAL
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170817
[Lr] Data última revisão:
170817
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160918
[St] Status:MEDLINE
[do] DOI:10.1007/s12630-016-0734-7


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[PMID]:27228229
[Au] Autor:D'Elia E; Ferrero P; Revera M; Iacovoni A; Gandolfi E; Senni M; Vanoli E
[Ad] Endereço:aCardiovascular Department, Hospital Papa Giovanni XXIII, Bergamo bInternal Medicine Department, University of Pavia, Pavia cCardiovascular Department, Hospital Auxologico, IRCCS, Milan dCardiovascular Department, Hospital ss Antonio e Biagio e Cesare Arrigo, Alessandria eCardiovascular Medicine Department, IRCCS Multimedica, Sesto San Giovanni fMolecular Medicine Department, University of Pavia, Pavia, Italy.
[Ti] Título:Clinical correlates of autonomic response during tilting test in hypertrophic cardiomyopathy.
[So] Source:J Cardiovasc Med (Hagerstown);18(4):255-261, 2017 Apr.
[Is] ISSN:1558-2035
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:AIMS: The aim is to investigate autonomic nervous system imbalance in hypertrophic cardiomyopathy (HCM) by combining echocardiographic morphological and functional parameters with the analysis of the autonomic responses to orthostatic stress. METHODS: A 10-min tilting test and a transthoracic echocardiogram focused on ventricular septal systolic (S wave) and diastolic function (isovolumic relaxation time) were performed. Low frequency on high frequency ratio (LF/HF) and RR variation (variation of beat to beat intervals) in response to passive orthostatism were used as measures of sympathetic reflex activation [delta LF/HF (D-LF/HF) and delta RR (DRR), respectively]. Brain natriuretic peptide was measured. RESULTS: A total of 50 HCM patients were categorized in two groups: D-LF/HF more than 0 (group 1, sympathetic response) and D-LF/HF 0 or less (group 2, parasympathetic response). Patients in group 2 had higher New York Heart Association class, a more frequent history of atrial fibrillation (38 versus 9% P = 0.04) or syncope (46 versus 12% P = 0.01) and an increased septal isovolumic relaxation time (122 versus 82 ms P = 0.02). The same categorization was made according to lowest quartile DRR (DRR at least 23 ms, group 1: sympathetic response; DRR less than 23 ms, group 2: parasympathetic response). In group 2, patients were older, with advanced New York Heart Association class and higher history of atrial fibrillation. CONCLUSIONS: Autonomic response to passive orthostatism in HCM appears correlated with specific functional features of the hypertrophic heart. Altered neural afferent traffic from the localized area of segmental hypertrophy resulted in autonomic changes with a blunted sympathetic response, and an inappropriate vagal activation, especially in patients with history of atrial fibrillation or syncope.
[Mh] Termos MeSH primário: Cardiomiopatia Hipertrófica/diagnóstico
Coração/inervação
Intolerância Ortostática/fisiopatologia
Postura
Reflexo
Sistema Nervoso Simpático/fisiopatologia
Teste da Mesa Inclinada
Nervo Vago/fisiopatologia
[Mh] Termos MeSH secundário: Adulto
Biomarcadores/sangue
Cardiomiopatia Hipertrófica/sangue
Cardiomiopatia Hipertrófica/fisiopatologia
Diástole
Ecocardiografia Doppler em Cores
Feminino
Coração/diagnóstico por imagem
Frequência Cardíaca
Seres Humanos
Masculino
Meia-Idade
Peptídeo Natriurético Encefálico/sangue
Valor Preditivo dos Testes
Sístole
Função Ventricular Esquerda
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Biomarkers); 114471-18-0 (Natriuretic Peptide, Brain)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170816
[Lr] Data última revisão:
170816
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160527
[St] Status:MEDLINE
[do] DOI:10.2459/JCM.0000000000000406



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