Evidence map›Paper›PMID 38980470›Full record

ReviewClinical autonomic research : official journal of the Clinical Autonomic Research Society2024

Serotonin and vasovagal syncope.

Mohammed Alsaleh, Aryan Talati, Satish R Raj, Robert S Sheldon

Abstract readReview
PubMed Publisher
In one paragraph

Review in Clinical autonomic research : official journal of the Clinical Autonomic Research Society, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Review
  2. Serotonin does not seem to play a major role in eliciting vasovagal syncope.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2025
    Article
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Mohammed AlsalehDepartment of Cardiac Sciences, Cumming School of Medicine, Libin Cardiovascular Institute, University of Calgary, GAA04 HRIC Building 3280 Hospital Drive Calgary, Calgary, AB, T2N 4Z6, Canada.
Aryan TalatiDepartment of Cardiac Sciences, Cumming School of Medicine, Libin Cardiovascular Institute, University of Calgary, GAA04 HRIC Building 3280 Hospital Drive Calgary, Calgary, AB, T2N 4Z6, Canada.
Satish R RajDepartment of Cardiac Sciences, Cumming School of Medicine, Libin Cardiovascular Institute, University of Calgary, GAA04 HRIC Building 3280 Hospital Drive Calgary, Calgary, AB, T2N 4Z6, Canada.
Robert S SheldonDepartment of Cardiac Sciences, Cumming School of Medicine, Libin Cardiovascular Institute, University of Calgary, GAA04 HRIC Building 3280 Hospital Drive Calgary, Calgary, AB, T2N 4Z6, Canada. sheldon@ucalgary.ca.ORCID http://orcid.org/0000-0002-3463-4082

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe goal of this manuscript was to review the biological and clinical evidence that serotonin neurotransmission might play an important role in the  physiology and treatment of vasovagal syncope.

methodsThe authors reviewed PubMed and handsearches of secondary sources for papers related to the Bezold-Jarisch reflex and serotonin, the plausible involvement of the Bezold-Jarisch reflex in vasovagal syncope, and three lines of clinical evidence involving serotonin and the syncope.

resultsThe Bezold-Jarisch reflex was first described following the infusion of veratrum alkaloids into animals in the 19th century. The reflex is triggered by serotonin stimulation chemoreceptors and mechanoreceptors in the the left ventricle. The afferent component of the reflex is carried by unmyelinated type C vagal nerve fibers, which results in parasympathetic efferent stimulation that causes bradycardia. The similarity of the combination of hypotension and bradycardia in the Bezold-Jarisch reflex and in vasovagal syncope led to the suggestion that the reflex was the cause of the syndrome.  Three lines of evidence implicate the serotonin 5HT3 receptors in the heart in the reflex. There is genetic and physiologic evidence for the serotonin 5HT1A and 5HT3 receptors and the serotonin reuptake transporter (SERT). Acute blockade of SERT induces vasovagal syncope in humans undergoing head-up tilt table testing, and SERT inhibition reduces hypotension and bradycardia during spinal anaesthesia. Finally, three randomized clinical trials of SERT inhibitors uniformly reported that they significantly reduce the likelihood of vasovagal syncope recurrences.

conclusionMultiple lines of evidence implicate serotonin neurotransmission in the cause of vasovagal syncope.

Indexed as

SerotoninSyncope, VasovagalAnimalsHumansReflexSerotoninBezold-Jarisch reflexClinical trialsSerotoninVasovagal syncope

Identifiers

What OpenQuestion holds

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Registered trials

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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.