ArticleArquivos brasileiros de cardiologia2016
Reduced Systolic Volume: Main Pathophysiological Mechanism in Patients with Orthostatic Intolerance?
Article in Arquivos brasileiros de cardiologia, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.
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Who cites it
4 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Efficacy of β-Blockers on Postural Tachycardia Syndrome in Children and Adolescents: A Systematic Review and Meta-Analysis.Frontiers in pediatrics · 2019Pooled it
- Differential hemodynamic adaptations to tilt test in patients with idiopathic atrial fibrillation.Physiological reports · 2024Article
- Vasoactive Biomarkers in Patients With Vasovagal Syncope During Head-Up Tilt Test: A Case-Control Study.Clinical Medicine Insights. Cardiology · 2022Article
- Dysautonomia: A Forgotten Condition - Part 1.Arquivos brasileiros de cardiologia · 2021Article
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Authors and funding
9 authors.
Funding
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Abstract
backgroundOrthostatic intolerance patients' pathophysiological mechanism is still obscure, contributing to the difficulty in their clinical management.
objectiveTo investigate hemodynamic changes during tilt test in individuals with orthostatic intolerance symptoms, including syncope or near syncope.
methodsSixty-one patients who underwent tilt test at - 70° in the phase without vasodilators were divided into two groups. For data analysis, only the first 20 minutes of tilting were considered. Group I was made up of 33 patients who had an increase of total peripheral vascular resistance (TPVR) during orthostatic position; and Group II was made up of 28 patients with a decrease in TPVR (characterizing insufficient peripheral vascular resistance). The control group consisted of 24 healthy asymptomatic individuals. Hemodynamic parameters were obtained by a non-invasive hemodynamic monitor in three different moments (supine position, tilt 10' and tilt 20') adjusted for age.
resultsIn the supine position, systolic volume (SV) was significantly reduced in both Group II and I in comparison to the control group, respectively (66.4 ±14.9 ml vs. 81.8±14.8 ml vs. 101.5±24.2 ml; p<0.05). TPVR, however, was higher in Group II in comparison to Group I and controls, respectively (1750.5± 442 dyne.s/cm5 vs.1424±404 dyne.s/cm5 vs. 974.4±230 dyne.s/cm5; p<0.05). In the orthostatic position, at 10', there was repetition of findings, with lower absolute values of SV compared to controls (64.1±14.0 ml vs 65.5±11.3 ml vs 82.8±15.6 ml; p<0.05). TPVR, on the other hand, showed a relative drop in Group II, in comparison to Group I.
conclusionReduced SV was consistently observed in the groups of patients with orthostatic intolerance in comparison to the control group. Two different responses to tilt test were observed: one group with elevated TPVR and another with a relative drop in TPVR, possibly suggesting a more severe failure of compensation mechanisms.
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