Cerebrovascular mechanisms in neurocardiogenic syncope with and without postural tachycardia syndrome

Journal of the Autonomic Nervous System

Volumn 76, Issue 2-3, 1999, Pages 159-166

  Diehl, Rolf R ^a,b   Linden, Dieter ^a   Chalkiadaki, Aspasia ^a   Diehl, Anke ^a  

^a Krupp Hospital   (Germany)

^b ALFRIED KRUPP KRANKENHAUS   (Germany)

Author keywords

Autoregulation; Blood pressure; Cerebral blood flow; Syncope; Ultrasonics

Indexed keywords

ADULT; ARTERIAL PRESSURE; ARTICLE; AUTONOMIC NERVOUS SYSTEM; AUTOREGULATION; BLOOD FLOW VELOCITY; BRAIN BLOOD FLOW; CLINICAL ARTICLE; CONTROLLED STUDY; DOPPLER ECHOGRAPHY; HEART RATE; HUMAN; HYPOTENSION; MIDDLE CEREBRAL ARTERY; PRESSORECEPTOR REFLEX; PRIORITY JOURNAL; STANDING; SUPINE POSITION; SYNCOPE; TACHYCARDIA; TILTING; VASOCONSTRICTION; VASODILATATION;

EID: 0032997214     PISSN: 01651838     EISSN: None     Source Type: Journal    
DOI: 10.1016/S0165-1838(99)00013-2     Document Type: Article

References (48)

1. Aaslid, R., Junger, E., Newell, D.W., 1996. An improved method for evaluating cerebral autoregulation (abstract). Cerebrovasc. Dis. 6, 41, Suppl. 3.
2. Abbout, F.M., 1993. Neurocardiogenic syncope. N. Engl. J. Med. 328, 1117-1120.
3. Almquist, A., Goldenberg, I.F., Milstein, F., Chen, M.Y., Chen, X., Hansen, R., Gornick, C.C., Benditt, D.G., 1989. Provocation of bradycardia and hypotension by isoproterenol and upright posture in patients with unexplained syncope. N. Engl. J. Med. 320, 346-351.
4. Barcroft, H., Edholm, O.G., 1945. On the vasodilatation in human skeletal muscle during post-haemorrhagic fainting. J. Physiol. 104, 161-175.
5. Barron, S.A., Rogovski, Z., Kanter, Y., Hemli, Y., 1994. Parasympathetic autonomie neuropathy in diabetes mellitus: the heart is denervated more often than the pupil. Electromyogr. Clin. Neurophysiol. 34, 467-469.
6. Bill, A., Linder, J., 1976. Sympathetic control of cerebral blood flow in acute arterial hypertension. Acta Physiol. Scand. 96, 114-121.
7. Birch, A.A., Dirnhuber, M.J., Hartley-Davies, R., Ianotti, F., Neil-Dwyer, G., 1995. Assessment of autoregulation by means of periodic changes in blood pressure. Stroke 26, 834-837.
8. Bondar, R.L., Kassam, M.S., Stein, F., Dunphy, P.T., Fortney, S., Riedesel, M.L., 1995. Simultaneous cerebrovascular and cardiovascular responses during presyncope. Stroke 26, 1794-1800.
9. Daffertshofer, M., Hennerici, M., 1995. Cerebrovascular regulation and vasoneuronal coupling. J. Clin. Ultrasound 23, 125-138.
10. de Jong de Vos van Steenwijk, C.C., Wieling, W., Johannes, J.M., Harms, M.P., Kuis, W., Wesseling, K.H., 1995. Incidence and hemodynamic characteristics of near-fainting in healthy 6- to 16-year-old subjects. J. Am. Coll. Cardiol. 25, 1615-1621.
11. Diehl, R.R., Berlit, P., 1995. Die quantitative Kipptischuntersuchung mit TCD-Monitoring. Nervenarzt 66, 116-123.
12. Diehl, R.R., Berlit, P., 1996. Funktionelle Dopplersonographie in der Neurologie. Springer, Berlin.
13. Diehl, R.R., Daffertshofer, M., Hennerici, M., 1991. Cerebrovascular dysautoregulation: a new syndrome?. Ann. Neurol. 30, 244-245.
14. Diehl, R.R., Linden, D., Lücke, D., Berlit, P., 1995. Phase relationship between cerebral blood flow velocity and blood pressure: a clinical test of autoregulation. Stroke 26, 1801-1804.
15. Diehl, R.R., Linden, D., Chalkiadaki, A., Ringelstein, E.B., Berlit, P., 1996. Transcranial Doppler during neurocardiogenic syncope. Clin. Auton. Res. 6, 71-74.
16. Diehl, R.R., Linden, D., Berlit, P., 1997. Determinants of heart rate variability during deep breathing: basic findings and clinical applications. Clin. Auton. Res. 7, 131-135.
17. Diehl, R.R., Linden, D., Lücke, D., Berlit, P., 1998. Spontaneous blood pressure oscillations and cerebral autoregulation. Clin. Auton. Res. 8, 7-12.
18. Ferrer, T., Perez-Jimenez, A., Perez-Sales, P., Alvarez, E., Ramos, M.J., 1996. Autonomie profile of subjects prone to fainting. J. Neurol. Sci. 135, 38-42.
19. Fitch, W., Mackenzie, E.T., Harper, A.M., 1975. Effects of decreasing arterial blood pressure on cerebral blood flow in the baboon. Circ. Res. 37, 550-557.
20. Fitzpatrick, A.P., Banner, N., Cheng, A., Yacoub, M., Sutton, R., 1993. Vasovagal reactions may occur after orthotropic heart transplantation. J. Am. Coll. Cardiol. 21, 1132-1137.
21. Giller, C.A., Levine, B.D., Meyer, Y., Buckey, J.C., Lane, L.D., Borchers, D.J., 1992. The cerebral hemodynamics of normotensive hypovolemia during lower-body negative pressure. J. Neurosurg. 76, 961-966.
22. Grubb, B.P., Gerard, G., Roush, K., Temesy-Armos, P., Montford, P., Elliott, L., Hahn, H., Brewster, P., 1991. Cerebral vasoconstriction during head-upright tilt-induced vasovagal syncope. A paradoxic and unexpected response. Circulation 84, 1157-1164.
23. Grubb, B.P., Rubin, A.M., Wolfe, D., Temsey-Armos, P., Hahn, H., Elliott, L., 1992. Head-upright tilt-table testing: a useful tool in the evaluation and management of recurrent vertigo of unknown origin associated with near-syncope or syncope. Otolaryngol. Head Neck Surg. 107, 570-576.
24. Grubb, B.P., Samoil, D., Kosinski, D., Wolfe, D., Brewster, P., Elliott, L., Hahn, H., 1998. Cerebral syncope: loss of consciousness associated with cerebral vasoconstriction in the absence of systemic hypotension. Pacing Clin. Electrophysiol. 21, 652-658.
25. Hoeldtke, R.D., Davis, K.M., 1991. The orthostatic tachycardia syndrome: evaluation of autonomie function and treatment with octreotide and ergot alkaloids. J. Clin. Endocrinol. Metab. 73, 132-139.
26. Hoeldtke, R.D., Dworkin, G.E., Gaspar, S.R., Israel, B.C., 1989. Sympathotonic orthostatic hypotension: a report of four cases. Neurology 39, 34-40.
27. Jacobs, M.C., Goldstein, D.S., Willemsen, J.J., Smits, P., Thien, T., Lenders, J.W., 1996. Differential effects of low- and high-intensity lower body negative pressure on noradrenaline and adrenaline kinetics in humans. Clin. Sci. Colch. 90, 337-343.
28. Kaufmann, H., 1995. Neurally mediated syncope: pathogenesis, diagnosis, and treatment. Neurology 45, S12-S18, Suppl. 4.
29. Khurana, R.K., 1995. Orthostatic intolerance and orthostatic tachycardia: a heterogeneous disorder. Clin. Auton. Res. 5, 12-18.
30. Lagi, A., Cipriani, M., Fattorini, L., Paggetti, C., Macerata, A., 1994. Observations on the arterial baroreflex in neurally mediated vasodepressor syncope. Clin. Auton. Res. 5, 307-309.
31. Levine, B.D., Giller, C.A., Lane, L.D., Buckey, J.C., Blomqvist, C.G., 1994. Cerebral versus systemic hemodynamics during graded orthostatic stress in humans. Circulation 90, 298-306.
32. Lewis, T., 1932. A lecture on vasovagal syncope and carotid sinus mechanism. Br. Med. J. 1, 873-876.
33. Linden, D., Diehl, R.R., 1996a. Comparison of standard autonomie tests and power spectral analysis in normal adults. Muscle Nerve 19, 556-562.
34. Linden, D., Diehl, R.R., 1996b. Estimation of baroreflex sensitivity using transfer function analysis: normal values and theoretical considerations. Clin. Auton. Res. 6, 157-161.
35. Low, P.A., Opfer-Gehrking, T.L., Textor, S.C., Schondorf, R., Suarez, G.A., Fealey, R.D., Camilleri, M., 1994. Comparison of the postural tachycardia syndrome (POTS) with orthostatic hypotension due to autonomie failure. J. Auton. Nerv. Syst. 50, 181-188.
36. Low, P.A., Opfer-Gehrking, T.L., Textor, S.C., Benaroch, E.E., Shen, W.K., Schondorf, R., Suarez, G.A., Rummans, T.A., 1995. Postural tachycardia syndrome (POTS). Neurology 45, S19-S25, Suppl. 5.
37. Njemanze, P., 1993. Cerebral circulation dysfunction and hemodynamic abnormalities in syncope during upright tilt test. Can. J. Cardiol. 9, 238-242.
38. Norsk, P., Ellegaard, P., Videbaek, R., Stadeager, C., Jessen, F., Johansen, L.B., Kristensen, M.S., Kamegai, M., Warberg, J., Christensen, N.J., 1993. Arterial pulse pressure and vasopressin release in humans during lower body negative pressure. Am. J. Physiol. 264, R1024-R1030.
39. Polinsky, R.J., Kopin, I.J., Ebert, M.H., Weise, V., 1981. Pharmacologic distinction of different orthostatic hypotension syndromes. Neurology 31, 1-7.
40. Rosen, S.G., Cryer, P.E., 1982. Postural tachycardia syndrome. Am. J. Med. 72, 847-850.
41. Sandroni, P., Opfer-Gehrking, T.L., Benarroch, E.E., Shen, W.K., Low, P.A., 1996. Certain cardiovascular indices predict syncope in the postural tachycardia syndrome. Clin. Auton. Res. 6, 225-231.
42. Schondorf, R., Benoit, J., Wein, T., 1997. Cerebrovascular and cardiovascular measurements during neurally mediated syncope induced by head-up tilt. Stroke 28, 1564-1568.
43. Sneddon, J.F., Counihan, P.J., Bashir, Y., Haywood, G.A., Ward, D.E., Camm, A.J., 1993. Assessment of autonomie function in patients with neurally mediated syncope: augmented cardiopulmonary baroreceptor responses to graded orthostatic stress. J. Am. Coll. Cardiol. 21, 1193-1198.
44. Streeten, D.H.P., 1990. Pathogenesis of hyperadrenergic orthostatic hypotension: evidence of disordered venous innervation exclusively in the lower limbs. J. Clin. Invest. 86, 1582-1588.
45. Streeten, D.H., Scullard, T.F., 1996. Excessive gravitational blood pooling caused by impaired venous tone is the predominant non-cardiac mechanism of orthostatic intolerance. Clin. Sci. Colch. 90, 277-285.
46. Taylor, J.A., Halliwill, J.R., Brown, T.E., Hayano, J., Eckberg, D.L., 1995. 'Non-hypotensive' hypovolaemia reduces ascending aortic dimensions in humans. J. Physiol. 483, 289-298.
47. Thomson, H.L., Wright, K., Frennaeux, M., 1997. Baroreflex sensitivity in patients with vasovagal syncope. Circulation 95, 395-400.
48. van Lieshout, J.J., Wieling, W., Karemaker, J.M., Eckberg, D.L., 1991. The vasovagal response. Clin. Sci. 81, 576-586.