Tags

Type your tag names separated by a space and hit enter

Midodrine in neurally mediated syncope: a double-blind, randomized, crossover study.
Ann Neurol. 2002 Sep; 52(3):342-5.AN

Abstract

Neurally mediated syncope is the most frequent cause of syncope in patients without structural heart disease. Its most common trigger is a reduction in venous return to the heart due to excessive venous pooling in the legs. We conducted a double-blind, randomized, crossover trial to investigate the efficacy of midodrine, a selective alpha-1 adrenergic agonist that decreases venous capacitance, in preventing neurally mediated syncope triggered by passive head-up tilt. Twelve patients with history of recurrent neurally mediated syncope, which was reproduced during head-up tilt, were randomized to receive a nonpressor dose of midodrine (5mg) or placebo on day 1 and the opposite on day 3. One hour after drug or placebo administration, patients underwent 60-degree head-up tilt lasting 40 minutes (unless hypotension or bradycardia developed first). In the supine position, midodrine produced no significant change in blood pressure or heart rate. The responses to head-up tilt were significantly different on the midodrine and the placebo day: on the placebo day, 67% (8/12) of the subjects suffered neurally mediated syncope, whereas only 17% (2/12) of the subjects developed neurally mediated syncope on the midodrine day (p < 0.02). These results indicate that midodrine significantly improves orthostatic tolerance during head-up tilt in patients with recurrent neurally mediated syncope.

Authors+Show Affiliations

Department of Neurology, Mount Sinai School of Medicine, New York, NY 10029, USA. horacio.kaufmann@mssm.eduNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

12205647

Citation

Kaufmann, Horacio, et al. "Midodrine in Neurally Mediated Syncope: a Double-blind, Randomized, Crossover Study." Annals of Neurology, vol. 52, no. 3, 2002, pp. 342-5.
Kaufmann H, Saadia D, Voustianiouk A. Midodrine in neurally mediated syncope: a double-blind, randomized, crossover study. Ann Neurol. 2002;52(3):342-5.
Kaufmann, H., Saadia, D., & Voustianiouk, A. (2002). Midodrine in neurally mediated syncope: a double-blind, randomized, crossover study. Annals of Neurology, 52(3), 342-5.
Kaufmann H, Saadia D, Voustianiouk A. Midodrine in Neurally Mediated Syncope: a Double-blind, Randomized, Crossover Study. Ann Neurol. 2002;52(3):342-5. PubMed PMID: 12205647.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Midodrine in neurally mediated syncope: a double-blind, randomized, crossover study. AU - Kaufmann,Horacio, AU - Saadia,Daniela, AU - Voustianiouk,Andrei, PY - 2002/9/3/pubmed PY - 2002/9/27/medline PY - 2002/9/3/entrez SP - 342 EP - 5 JF - Annals of neurology JO - Ann Neurol VL - 52 IS - 3 N2 - Neurally mediated syncope is the most frequent cause of syncope in patients without structural heart disease. Its most common trigger is a reduction in venous return to the heart due to excessive venous pooling in the legs. We conducted a double-blind, randomized, crossover trial to investigate the efficacy of midodrine, a selective alpha-1 adrenergic agonist that decreases venous capacitance, in preventing neurally mediated syncope triggered by passive head-up tilt. Twelve patients with history of recurrent neurally mediated syncope, which was reproduced during head-up tilt, were randomized to receive a nonpressor dose of midodrine (5mg) or placebo on day 1 and the opposite on day 3. One hour after drug or placebo administration, patients underwent 60-degree head-up tilt lasting 40 minutes (unless hypotension or bradycardia developed first). In the supine position, midodrine produced no significant change in blood pressure or heart rate. The responses to head-up tilt were significantly different on the midodrine and the placebo day: on the placebo day, 67% (8/12) of the subjects suffered neurally mediated syncope, whereas only 17% (2/12) of the subjects developed neurally mediated syncope on the midodrine day (p < 0.02). These results indicate that midodrine significantly improves orthostatic tolerance during head-up tilt in patients with recurrent neurally mediated syncope. SN - 0364-5134 UR - https://www.unboundmedicine.com/medline/citation/12205647/Midodrine_in_neurally_mediated_syncope:_a_double_blind_randomized_crossover_study_ L2 - https://onlinelibrary.wiley.com/resolve/openurl?genre=article&amp;sid=nlm:pubmed&amp;issn=0364-5134&amp;date=2002&amp;volume=52&amp;issue=3&amp;spage=342 DB - PRIME DP - Unbound Medicine ER -