ArticleJournal of the American Heart Association2017
Mechanisms of Vasovagal Syncope in the Young: Reduced Systemic Vascular Resistance Versus Reduced Cardiac Output.
Article in Journal of the American Heart Association, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers.
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Who cites it
25 citing papers in PubMed, 59 citations in OpenAlex.
- From Mechanism to Management in Vasovagal Syncope: An Integrative Review.Journal of clinical medicine · 2026Review
- Progressive baroreflex dysfunction and hypotension preceding VVS: a vicious cycle?Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2025Article
- Cerebral Blood Flow in Orthostatic Intolerance.Journal of the American Heart Association · 2025Review
- Advances in diagnosis, management, and long-term outcomes of pediatric vasovagal syncope: a comprehensive review.Frontiers in cardiovascular medicine · 2025Review
- Association of supine and upright blood pressure differences with head-up tilt test outcomes in children with vasovagal syncope.Frontiers in pediatrics · 2025Article
- Cardioneuroablation for Drug Refractory Vasovagal Syncope After COVID-19 Infection.JACC. Case reports · 2024Article
- Variability of cardioinhibition in vasovagal syncope: differences between subgroups during cardioinhibition and beyond.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2023Article
- Decreased cardiac output: an integrative review.Revista brasileira de enfermagem · 2023Review
- Clinical and Autonomic Profile, and Modified Calgary Score for Children and Adolescents with Presumed Vasovagal Syncope Submitted to the Tilt Test.Arquivos brasileiros de cardiologia · 2023Observational
- [A 10-year retrospective analysis of spectrums and treatment options of orthostatic intolerance and sitting intolerance in children].Beijing da xue xue bao. Yi xue ban = Journal of Peking University. Health sciences · 2022Article
- Biomarkers and Hemodynamic Parameters in the Diagnosis and Treatment of Children with Postural Tachycardia Syndrome and Vasovagal Syncope.International journal of environmental research and public health · 2022Review
- Vasoactive Biomarkers in Patients With Vasovagal Syncope During Head-Up Tilt Test: A Case-Control Study.Clinical Medicine Insights. Cardiology · 2022Article
- The impact of atrial mechanical function on age-dependent presentation of neurocardiogenic syncope.Clinical cardiology · 2021Article
- Electrocardiographic Patterns in Patients with Neurally Mediated Syncope.Medicina (Kaunas, Lithuania) · 2021Review
- Advance in the understanding of vasovagal syncope in children and adolescents.World journal of pediatrics : WJP · 2021Review
- The Influence of a Total Body Resistance Training Program on Autonomic Modulation and Strength Variables in Young Adults.International journal of exercise science · 2021Article
- Vitamin D Deficiency in Children With Vasovagal Syncope Is Associated With Impaired Circadian Rhythm of Blood Pressure.Frontiers in neuroscience · 2021Article
- Differential diagnosis of vasovagal syncope and postural tachycardia syndrome in children.World journal of pediatrics : WJP · 2020Article
- Timing of Circulatory and Neurological Events in Syncope.Frontiers in cardiovascular medicine · 2020Review
- Mechanisms of tilt-induced vasovagal syncope in healthy volunteers and postural tachycardia syndrome patients without past history of syncope.Physiological reports · 2019Article
Corrections and comments
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Authors and funding
6 authors at 5 institutions in 4 countries.
Funding
Abstract
backgroundSyncope is a sudden transient loss of consciousness and postural tone caused by cerebral hypoperfusion. The most common form is vasovagal syncope (VVS). Presyncopal progressive early hypotension in older VVS patients is caused by reduced cardiac output (CO); younger patients have reduced systemic vascular resistance (SVR). Using a priori criteria for reduced CO (↓CO) and SVR (↓SVR), we studied 48 recurrent young fainters comparing subgroups of VVS with VVS-↓CO, VVS-↓SVR, and both VVS-↓CO&↓SVR. METHODS AND
resultsSubjects were studied supine and during 70-degrere upright tilt with a Finometer to continuously measure blood pressure, CO, and SVR and impedance plethysmography to estimate thoracic, splanchnic, pelvic, and calf blood volumes, blood flows, and vascular resistances and electrocardiogram to measure heart rate and rhythm. Central blood volume was decreased in all VVS compared to control. VVS-↓CO was associated with decreased splanchnic blood flow and increased splanchnic blood pooling compared to control. Seventy-five percent of VVS patients had reduced SVR, including 23% who also had reduced CO. Many VVS-↓SVR increased CO during tilt, with no difference in splanchnic pooling, caused by significant increases in splanchnic blood flow and reduced splanchnic resistance. VVS-↓CO&↓SVR patients had splanchnic pooling comparable to VVS-↓CO patients, but SVR comparable to VVS-↓SVR. Splanchnic vasodilation was reduced, compared to VVS-↓SVR, and venomotor properties were similar to control. Combined splanchnic pooling and reduced SVR produced the earliest faints among the VVS groups.
conclusionsBoth ↓CO and ↓SVR occur in young VVS patients. ↓SVR is predominant in VVS and is caused by impaired splanchnic vasoconstriction.
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Registered trials
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