Trial reportClinical autonomic research : official journal of the Clinical Autonomic Research Society2000
Noninvasive detection of sympathetic neurocirculatory failure.
Trial report in Clinical autonomic research : official journal of the Clinical Autonomic Research Society, 2000. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
31 citing papers in PubMed, 64 citations in OpenAlex.
- Effects of carbidopa and entacapone on the metabolic fate of the norepinephrine prodrug L-DOPS.Journal of clinical pharmacology · 2011Trial
- The Valsalva maneuver: screening for drug-induced baroreflex dysfunction.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2009Trial
- Utility and best practices for clinical diagnostic testing of the autonomic nervous system: A Consensus Statement Endorsed by the American Autonomic Society and the American Association of Neuromuscular & Electrodiagnostic Medicine.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2026Review
- Distinct Sympathoneural and Cardiovagal Domains of Arterial Baroreflex Function in Autonomic Synucleinopathies.Research square · 2026Article
- Vestibulo-sympathetic interaction and otolith function in postural orthostatic tachycardia syndrome.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2026Article
- 3,4-Dihydroxyphenylglycol levels separate multiple system atrophy from Parkinson disease with orthostatic hypotension.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2025Observational
- Review
- A pathophysiological biomarker combination separates Lewy body from non-Lewy body neurogenic orthostatic hypotension .Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2024Observational
- Tilt-evoked, breathing-driven blood pressure oscillations: Independence from baroreflex-sympathoneural function.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2024Observational
- CardiacClinical autonomic research : official journal of the Clinical Autonomic Research Society · 2023Review
- Blood pressure during ambulation: are noninvasive beat-by-beat finger measures and intermittent brachial measures comparable?Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2023Article
- IsClinical autonomic research : official journal of the Clinical Autonomic Research Society · 2022Article
- Beat-to-beat blood pressure and heart rate responses to the Valsalva maneuver.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2017Review
- Article
- Plasma biomarkers of decreased vesicular storage distinguish Parkinson disease with orthostatic hypotension from the parkinsonian form of multiple system atrophy.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2015Article
- Quantitative indices of baroreflex-sympathoneural function: application to patients with chronic autonomic failure.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2014Article
- Dysautonomia in Parkinson disease.Comprehensive Physiology · 2014Review
- Cardiovascular dysautonomia in Parkinson disease: from pathophysiology to pathogenesis.Neurobiology of disease · 2012Review
- Intra-neuronal vesicular uptake of catecholamines is decreased in patients with Lewy body diseases.The Journal of clinical investigation · 2011Article
- Assessment of sympathetic index from the Valsalva maneuver.Neurology · 2011Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors at 2 institutions in 2 countries.
Funding
Abstract
In sympathetic neurocirculatory failure (SNF), reflexive sympathetically mediated cardiovascular stimulation does not compensate for decreased cardiac filling. This explains orthostatic hypotension in chronic primary autonomic failure (CPAF). During phase 2 of the Valsalva maneuver (phase 2_L), blood pressure increases from its peak. During phase 4, blood pressure normally "overshoots" the baseline. Because these changes depend on sympathetically mediated cardiovascular stimulation, a progressive decrease in pressure during phase 2 and absence of the overshoot in phase 4 may indicate SNF. Moreover, because beat-to-beat blood pressure can be measured noninvasively using a photoplethysmographic or tonometric device, evaluating reflexive pressure responses might enable noninvasive diagnosis of SNF. This study assessed the relative frequencies of abnormal phase 2_L and phase 4 blood pressure in patients with CPAF and orthostatic hypotension and whether noninvasive measurement of beat-to-beat blood pressure can be used to diagnose SNF in patients. Twenty patients with chronic primary autonomic failure and orthostatic hypotension and 50 comparison patients, including several with CPAF but lacking orthostatic hypotension, underwent arterial pressure monitoring during performance of the Valsalva maneuver. Of the 20 patients with CPAF and orthostatic hypotension, all had an abnormal phase 2_L or phase 4 pressure response (sensitivity 100%), whereas only 3 of the 50 comparison patients had an abnormal response in either phase (specificity 94%). Seventeen patients with CPAF and orthostatic hypotension had abnormal responses in both phases (sensitivity 85%), but none of the comparison patients had such findings in both phases (specificity 100%). Of 13 patients in whom beat-to-beat blood pressure was recorded simultaneously invasively and noninvasively, all had abnormal blood pressure responses during phase 2_L and phase 4, whereas none of 29 comparison patients had such symptoms. Detection of abnormal blood pressure responses during phase 2_L or phase 4 of the Valsalva maneuver is a highly sensitive test for SNF. Abnormal pressure during these phases appears to identify SNF specifically. Noninvasive measurements can detect both of these abnormalities.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.