Influence of age on syncope following prolonged exercise: Differential responses but similar orthostatic intolerance

Journal of Physiology

Volumn 587, Issue 24, 2009, Pages 5959-5969

  Murrell, Carissa ^a   Cotter, James D ^a   George, Keith ^b   Shave, Robert ^c   Wilson, Luke ^a   Thomas, Kate ^a   Williams, Michael J A ^a   Lowe, Tim ^d   Ainslie, Philip N ^e  

^a UNIVERSITY OF OTAGO   (New Zealand)

^b LIVERPOOL JOHN MOORES UNIVERSITY   (United Kingdom)

^c BRUNEL UNIVERSITY   (United Kingdom)

^d THE NEW ZEALAND INSTITUTE FOR PLANT AND FOOD RESEARCH LIMITED   (New Zealand)

^e UNIVERSITY OF BRITISH COLUMBIA   (Canada)

Author keywords

[No Author keywords available]

Indexed keywords

ADULT; AGE DISTRIBUTION; AGED; ARTERY BLOOD FLOW; ARTICLE; ATHLETE; BLOOD FLOW VELOCITY; BLOOD PRESSURE MEASUREMENT; BRAIN BLOOD FLOW; BRAIN FUNCTION; CARDIOVASCULAR RESPONSE; CONTROLLED STUDY; DOPPLER ECHOGRAPHY; EXERCISE; FEMALE; HEAD TILTING; HEART RATE; HEART STROKE VOLUME; HUMAN; HUMAN EXPERIMENT; MALE; MEASUREMENT; MIDDLE CEREBRAL ARTERY; NORMAL HUMAN; ORTHOSTATIC HYPOTENSION; ORTHOSTATIC STRESS; PHYSICAL TOLERANCE; PRESYNCOPE; PRIORITY JOURNAL; RUNNING; STANDING; SUPINE POSITION; SYNCOPE; VASCULAR RESISTANCE; VENOUS OXYGEN TENSION; AEROBIC CAPACITY; AGE; BODY HEIGHT; BODY MASS; BRAIN VASCULAR RESISTANCE; DIASTOLIC BLOOD PRESSURE; ENVIRONMENTAL TEMPERATURE; EXERCISE TOLERANCE; FAINTNESS; HEMODYNAMICS; HUMIDITY; HYPOTENSION; LUNG GAS EXCHANGE; MEAN ARTERIAL PRESSURE; ORTHOSTATIC INTOLERANCE; OXYGEN CONSUMPTION; PLASMA VOLUME; SYSTOLIC BLOOD PRESSURE; VERY ELDERLY;

ADOLESCENT; ADULT; AGING; EXERCISE TOLERANCE; FEMALE; HUMANS; MALE; ORTHOSTATIC INTOLERANCE; PHYSICAL ENDURANCE; PHYSICAL EXERTION; SYNCOPE; YOUNG ADULT;

EID: 72549109704     PISSN: 00223751     EISSN: 14697793     Source Type: Journal    
DOI: 10.1113/jphysiol.2009.179549     Document Type: Article

References (42)

1. Buijs PC, Krabbe-Hartkamp MJ, Bakker CJ, de Lange EE, Ramos LM, Breteler MM, Mali WP. Effect of age on cerebral blood flow: measurement with ungated two-dimensional phase-contrast MR angiography in 250 adults. Radiology 1998, 209:667-674.
2. Cooke WH, Rickards CA, Ryan KL, Kuusela TA, Convertino VA. Muscle sympathetic nerve activity during intense lower body negative pressure to presyncope in humans. J Physiol 2009
3. Dalsgaard MK. Fuelling cerebral activity in exercising man. J Cereb Blood Flow Metab 2006, 26:731-750.
4. Davis JE, Fortney SM. Effect of fluid ingestion on orthostatic responses following acute exercise. Int J Sports Med 1997, 18:174-178.
5. Dinenno FA, Joyner MJ. Alpha-adrenergic control of skeletal muscle circulation at rest and during exercise in aging humans. Microcirculation 2006, 13:329-341.
6. Ferrari AU, Radaelli A, Centola M. Invited review: aging and the cardiovascular system. J Appl Physiol 2003, 95:2591-2597.
7. Ferrari M, Mottola L, Quaresima V. Principles, techniques, and limitations of near infrared spectroscopy. Can J Appl Physiol 2004, 29:463-487.
8. Franco Folino A. Cerebral autoregulation and syncope. Prog Cardiovasc Dis 2007, 50:49-80.
9. Franke WD, Johnson CP, Steinkamp JA, Wang R, Halliwill JR. Cardiovascular and autonomic responses to lower body negative pressure: do not explain gender differences in orthostatic tolerance. Clin Auton Res 2003, 13:36-44.
10. Giller CA, Bowman G, Dyer H, Mootz L, Krippner W. Cerebral arterial diameters during changes in blood pressure and carbon dioxide during craniotomy. Neurosurgery 1993, 32:737-741. discussion 741-732
11. Gratze G, Rudnicki R, Urban W, Mayer H, Schlogl A, Skrabal F. Hemodynamic and autonomic changes induced by Ironman: prediction of competition time by blood pressure variability. J Appl Physiol 2005, 99:1728-1735.
12. Halliwill JR. Mechanisms and clinical implications of post-exercise hypotension in humans. Exerc Sport Sci Rev 2001, 29:65-70.
13. Halliwill JR, Taylor JA, Eckberg DL. Impaired sympathetic vascular regulation in humans after acute dynamic exercise. J Physiol 1996, 495:279-288.
14. Hanel B, Teunissen I, Rabol A, Warberg J, Secher NH. Restricted postexercise pulmonary diffusion capacity and central blood volume depletion. J Appl Physiol 1997, 83:11-17.
15. Hart E, Dawson E, Rasmussen P, George K, Secher NH, Whyte G, Shave R. β-Adrenergic receptor desensitization in man: insight into post-exercise attenuation of cardiac function. J Physiol 2006, 577:717-725.
16. Ide K, Pott F, Van Lieshout JJ, Secher NH. Middle cerebral artery blood velocity depends on cardiac output during exercise with a large muscle mass. Acta Physiol Scand 1998, 162:13-20.
17. Jellema WT, Imholz BP, van Goudoever J, Wesseling KH, van Lieshout JJ. Finger arterial versus intrabrachial pressure and continuous cardiac output during head-up tilt testing in healthy subjects. Clin Sci (Lond) 1996, 91:193-200.
18. Kastrup A, Dichgans J, Niemeier M, Schabet M. Changes of cerebrovascular CO2 reactivity during normal aging. Stroke 1998, 29:1311-1314.
19. Kurbaan AS, Bowker TJ, Wijesekera N, Franzen AC, Heaven D, Itty S, Sutton R. Age and hemodynamic responses to tilt testing in those with syncope of unknown origin. J Am Coll Cardiol 2003, 41:1004-1007.
20. Laitinen T, Niskanen L, Geelen G, Lansimies E, Hartikainen J. Age dependency of cardiovascular autonomic responses to head-up tilt in healthy subjects. J Appl Physiol 2004, 96:2333-2340.
21. Levine BD, Giller CA, Lane LD, Buckey JC, Blomqvist CG. Cerebral versus systemic hemodynamics during graded orthostatic stress in humans. Circulation 1994, 90:298-306.
22. Lucas SJ, Cotter JD, Murrell C, Wilson L, Anson JG, Gaze DC, George K, Ainslie PN. Mechanisms of orthostatic intolerance following very prolonged exercise. J Appl Physiol 2008, 105:213-225.
23. Luft AR, Skalej M, Schulz JB, Welte D, Kolb R, Burk K, Klockgether T, Voight K. Patterns of age-related shrinkage in cerebellum and brainstem observed in vivo using three-dimensional MRI volumetry. Cereb Cortex 1999, 9:712-721.
24. Lynn BM, McCord JL, Halliwill JR. Effects of the menstrual cycle and sex on postexercise hemodynamics. Am J Physiol Regul Integr Comp Physiol 2007, 292:R1260-R1270.
25. MacDonald JR, MacDougall JD, Hogben CD. The effects of exercise duration on post-exercise hypotension. J Hum Hypertens 2000, 14:125-129.
26. Madsen P, Lyck F, Pedersen M, Olesen HL, Nielsen H, Secher NH. Brain and muscle oxygen saturation during head-up-tilt-induced central hypovolaemia in humans. Clin Physiol 1995, 15:523-533.
27. Murrell C, Wilson L, Cotter JD, Lucas S, Ogoh S, George K, Ainslie PN. Alterations in autonomic function and cerebral hemodynamics to orthostatic challenge following a mountain marathon. J Appl Physiol 2007, 103:88-96.
28. Novak V, Spies JM, Novak P, McPhee BR, Rummans TA, Low PA. Hypocapnia and cerebral hypoperfusion in orthostatic intolerance. Stroke 1998, 29:1876-1881.
29. Ogoh S, Brothers RM, Barnes Q, Eubank WL, Hawkins MN, Purkayastha S, O-Yurvati A, Raven PB. The effect of changes in cardiac output on middle cerebral artery mean blood velocity at rest and during exercise. J Physiol 2005, 569:697-704.
30. Ogoh S, Fisher JP, Purkayastha S, Dawson EA, Fadel PJ, White MJ, Zhang R, Secher NH, Raven PB. Regulation of middle cerebral artery blood velocity during recovery from dynamic exercise in humans. J Appl Physiol 2007, 102:713-721.
31. Pantano P, Baron JC, Lebrun-Grandie P, Duquesnoy N, Bousser MG, Comar D. Regional cerebral blood flow and oxygen consumption in human aging. Stroke 1984, 15:635-641.
32. Peebles K, Celi L, McGrattan K, Murrell C, Thomas K, Ainslie PN. Human cerebrovascular and ventilatory CO2 reactivity to end-tidal, arterial and internal jugular vein PCO2. J Physiol 2007, 584:347-357.
33. Schondorf R, Wieling W. Vasoconstrictor reserve in neurally mediated syncope. Clin Auton Res 2000, 10:53-55.
34. Serrador JM, Picot PA, Rutt BK, Shoemaker JK, Bondar RL. MRI measures of middle cerebral artery diameter in conscious humans during simulated orthostasis. Stroke 2000, 31:1672-1678.
35. Soller BR, Yang Y, Soyemi OO, Ryan KL, Rickards CA, Walz JM, Heard SO, Convertino VA. Noninvasively determined muscle oxygen saturation is an early indicator of central hypovolemia in humans. J Appl Physiol 2007
36. Sugawara J, Tanabe T, Miyachi M, Yamamoto K, Takahashi K, Iemitsu M, Otsuki T, Homma S, Maeda S, Ajisaka R, Matsuda M. Non-invasive assessment of cardiac output during exercise in healthy young humans: comparison between Modelflow method and Doppler echocardiography method. Acta Physiol Scand 2003, 179:361-366.
37. Tan MP, Parry SW. Vasovagal syncope in the older patient. J Am Coll Cardiol 2008, 51:599-606.
38. Thomas KN, Cotter JD, Galvin SD, Williams MJ, Willie CK, Ainslie PN. Initial orthostatic hypotension is unrelated to orthostatic tolerance in healthy young subjects. J Appl Physiol 2009, 107:506-517.
39. Van Beek AH, Claassen JA, Rikkert MG, Jansen RW. Cerebral autoregulation: an overview of current concepts and methodology with special focus on the elderly. J Cereb Blood Flow Metab 2008, 28:1071-1085.
40. Van Lieshout JJ, Wieling W, Karemaker JM, Secher NH. Syncope, cerebral perfusion, and oxygenation. J Appl Physiol 2003, 94:833-848.
41. Verheyden B, Liu J, van Dijk N, Westerhof BE, Reybrouck T, Aubert AE, Wieling W. Steep fall in cardiac output is main determinant of hypotension during drug-free and nitroglycerine-induced orthostatic vasovagal syncope. Heart Rhythm 2008, 5:1695-1701.
42. Yamaguchi F, Meyer JS, Sakai F, Yamamoto M. Normal human aging and cerebral vasoconstrictive responses to hypocapnia. J Neurol Sci 1979, 44:87-94.