ArticlePloS one2015
Orthostatic Changes in Hemodynamics and Cardiovascular Biomarkers in Dysautonomic Patients.
Article in PloS one, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers.
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Who cites it
26 citing papers in PubMed, 56 citations in OpenAlex.
- Article
- Plasma copeptin and markers of arterial disorder in patients with type 2 diabetes, a cross-sectional study.Cardiovascular diabetology · 2024Article
- Definitive aetiology of unexplained syncope after cardiovascular autonomic tests in a tertiary syncope unit.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 · 2023Article
- Sitting intolerance: A new disease entity in children and adolescents.Pediatric investigation · 2022Article
- Early and late-onset syncope: insight into mechanisms.European heart journal · 2022Article
- Vasoactive Biomarkers in Patients With Vasovagal Syncope During Head-Up Tilt Test: A Case-Control Study.Clinical Medicine Insights. Cardiology · 2022Article
- Cardiology meets neurology: clinical presentation and management of patients with primary neurogenic disorders and orthostatic intolerance.Herzschrittmachertherapie & Elektrophysiologie · 2021Review
- Clinical and neuroendocrinological characteristics of delayed orthostatic hypotension in Parkinson's disease.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2021Article
- Risks of adverse events in patients with orthostatic intolerance undergoing surgery with general anesthesia.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2021Article
- Severe orthostatic hypotension in otherwise uncomplicated Plasmodium vivax infection.Malaria journal · 2021Article
- Sitting-induced hemodynamic changes and association with sitting intolerance in children and adolescents: a cross-sectional study.Scientific reports · 2020Article
- Classical and Delayed Orthostatic Hypotension in Patients With Unexplained Syncope and Severe Orthostatic Intolerance.Frontiers in cardiovascular medicine · 2020Article
- Neurohormones in Vasovagal Syncope: Are They Important?Journal of the American Heart Association · 2019Article
- Impact of Cardiovascular Neurohormones on Onset of Vasovagal Syncope Induced by Head-up Tilt.Journal of the American Heart Association · 2019Article
- Treatment of Orthostatic Hypotension Due to Autonomic Dysfunction (Neurogenic Orthostatic Hypotension) in a Patient with Cardiovascular Disease and Parkinson's Disease.Cardiology and therapy · 2019Article
- Autonomic uprising: the tilt table test in autonomic medicine.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2019Review
- Pacing for Patients Suffering From Cardioinhibitory Vasovagal Syncope Using the Closed-Loop System.Frontiers in cardiovascular medicine · 2019Review
- Postural tachycardia syndrome - Diagnosis, physiology, and prognosis.Autonomic neuroscience : basic & clinical · 2018Review
- Cardiovascular risk after hospitalisation for unexplained syncope and orthostatic hypotension.Heart (British Cardiac Society) · 2018Article
- Cardiovascular autonomic dysfunction in patients with idiopathic diabetes insipidus.Pituitary · 2018Article
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundImpaired autonomic control of postural homeostasis results in orthostatic intolerance. However, the role of neurohormones in orthostatic intolerance has not been explained.
methodsSix-hundred-and-seventy-one patients (299 males; 55 ± 22 years) with unexplained syncope underwent head-up tilt (HUT) with serial blood sampling. Systolic blood pressure (SBP) and heart rate (HR) supine, after 3 min, and lowest BP/highest HR during HUT were recorded. Plasma levels of epinephrine, norepinephrine, renin, C-terminal-pro-arginine-vasopressin (CT-proAVP), C-terminal- endothelin-1 (CT-proET-1), and mid-regional-fragment of pro-atrial-natriuretic-peptide (MR-proANP) were determined at supine and 3 min of HUT. Multivariate-adjusted logistic regression model was applied to compare 1st (reference) with 4th quartile of 3 min and maximal ΔSBP/ΔHR (i.e. pronounced hypotension or tachycardia) vs. changes in neuroendocrine biomarkers, respectively.
resultsHigher resting CT-proET-1 predicted BP fall at 3 min (Odds ratio (OR) per 1 SD: 1.62, 95%CI 1.18-2.22; p = 0.003), and max BP fall during HUT (1.82, 1.28-2.61; p = 0.001). Higher resting CT-proAVP predicted BP fall at 3 min (1.33, 1.03-1.73; p = 0.03), which was also associated with increase in CT-proAVP (1.86, 1.38-2.51; p = 0.00005) and epinephrine (1.47, 1.12-1.92; p = 0.05) during HUT. Lower resting MR-proANP predicted tachycardia at 3 min (0.37, 0.24-0.59; p = 0.00003), and max tachycardia during HUT (0.47, 0.29-0.77; p = 0.002). Further, tachycardia during HUT was associated with increase in epinephrine (1.60, 1.15-2.21; p = 0.005), and norepinephrine (1.87, 1.38-2.53; p = 0.005).
conclusionsResting CT-proET-1 and CT-proAVP are increased in orthostatic hypotension, while resting MR-proANP is decreased in postural tachycardia. Moreover, early BP fall during orthostasis evokes increase in CT-proAVP and epinephrine, while postural tachycardia is associated with increase in norepinephrine and epinephrine.
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