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- Title
Pulse wave analysis of the aortic pressure waveform in patients with vasovagal syncope.
- Authors
Pecha, Simon; Hakmi, Samer; Wilke, Iris; Yildirim, Yalin; Hoffmann, Boris; Reichenspurner, Hermann; Willems, Stephan; Kodolitsch, Yskert; Aydin, Ali
- Abstract
Vascular reflex mechanisms contribute to vasovagal syncope. However, the alterations in central haemodynamics in patients with vasovagal syncope are unknown. 30 consecutive patients (36.5 ± 15 years, 14 females) with recurrent vasovagal syncope (VVS) and a positive tilt table test were compared to 39 age- and sex-matched controls (36.9 ± 16 years, 15 females) with a negative tilt table result and no history of syncope. Central aortic pressure parameters including augmentation index and central pulse pressure as markers of aortic stiffness were generated non-invasively by applanation tonometry of the radial artery and use of a validated mathematical transfer function. No difference in aortic augmentation index was observed between groups. (VVS 9 ± 2.6 vs. Control 11 ± 2.4, p = 0.8). However, in patients with vasovagal syncope the aortic pressure waveform significantly differed from healthy controls. A prolonged time to the peak of aortic pressure wave (aortic T2) was observed in patients with vasovagal syncope (226 ± 24 vs. 208 ± 21 ms, p = 0.001). Furthermore time to the first shoulder of the aortic pressure wave (aortic T1) was slightly shorter compared to healthy controls, but did not reach statistical significance (106 ± 22 vs. 110 ± 12 ms, p = 0.33). Patients with vasovagal syncope have an altered aortic pressure waveform at rest, but no signs of elevated aortic stiffness. The underlying mechanisms for these findings may potentially result from a complex imbalance of the autonomic nervous system with a continuous deregulation of the sympathetic and parasympathetic reflex arcs.
- Subjects
BLOOD pressure; HEMODYNAMICS; BIOMARKERS; RADIAL artery; ARTERIAL diseases; VAGUS nerve; SYNCOPE; COMPARATIVE studies
- Publication
Heart & Vessels, 2016, Vol 31, Issue 1, p74
- ISSN
0910-8327
- Publication type
Article
- DOI
10.1007/s00380-014-0576-6