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Effects of orthostatic self-training on head-up tilt testing and autonomic balance in patients with neurocardiogenic syncope.
J Cardiovasc Pharmacol. 2003 Jan; 41 Suppl 1:S73-6.JC

Abstract

To investigate the effectiveness and the mechanisms of an orthostatic self-training program for the prevention of neurocardiogenic syncope, 28 patients were treated with an orthostatic self-training program. Syncope was induced by head-up tilt testing (+ 80 degrees for 30 min) in all patients. The onset time of the tilt-induced syncope was 14 +/- 7 min following placement in the upright position. The orthostatic self-training program included standing against a wall without moving twice a day every day for a planned duration of up to 30 min at home. The head-up tilt response was re-evaluated after 24 +/- 6 days based on results of the self-training. In 12 of the 28 patients, the sympathovagal balance was also determined during the head-up tilt test before and after the training with power spectral analysis of heart rate variability using a maximal entropy method. Syncope was not observed in any patient after the training. Although the low frequency/high frequency ratio in the supine position was not different before and after the training, the ratio after 3 min in the upright position after the training decreased significantly compared with that before the training. High-frequency components in the supine and upright positions were not different before and after the training. We concluded that orthostatic self-training significantly improved symptoms in patients with tilt-induced neurocardiogenic syncope. Decreased sympathetic activity in the early stage of the upright position period may play an important role in the mechanisms of this therapy.

Authors+Show Affiliations

Abe H
Second Department of Internal Medicine, University of Occupational and Environmental Health, Yahatanishi, Kitakyushu, Japan. haru-abe@med.uoeh-u.ac.jp
Kohshi K
No affiliation info available
Nakashima Y
No affiliation info available

MeSH

AdultAutonomic Nervous SystemFemaleHeart RateHumansHypotension, OrthostaticMalePostureSelf CareSyncopeSyncope, Vasovagal

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

12688401

Citation

Abe, Haruhiko, et al. "Effects of Orthostatic Self-training On Head-up Tilt Testing and Autonomic Balance in Patients With Neurocardiogenic Syncope." Journal of Cardiovascular Pharmacology, vol. 41 Suppl 1, 2003, pp. S73-6.
Abe H, Kohshi K, Nakashima Y. Effects of orthostatic self-training on head-up tilt testing and autonomic balance in patients with neurocardiogenic syncope. J Cardiovasc Pharmacol. 2003;41 Suppl 1:S73-6.
Abe, H., Kohshi, K., & Nakashima, Y. (2003). Effects of orthostatic self-training on head-up tilt testing and autonomic balance in patients with neurocardiogenic syncope. Journal of Cardiovascular Pharmacology, 41 Suppl 1, S73-6.
Abe H, Kohshi K, Nakashima Y. Effects of Orthostatic Self-training On Head-up Tilt Testing and Autonomic Balance in Patients With Neurocardiogenic Syncope. J Cardiovasc Pharmacol. 2003;41 Suppl 1:S73-6. PubMed PMID: 12688401.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effects of orthostatic self-training on head-up tilt testing and autonomic balance in patients with neurocardiogenic syncope. AU - Abe,Haruhiko, AU - Kohshi,Kiyotaka, AU - Nakashima,Yasuhide, PY - 2003/4/12/pubmed PY - 2003/6/28/medline PY - 2003/4/12/entrez SP - S73 EP - 6 JF - Journal of cardiovascular pharmacology JO - J Cardiovasc Pharmacol VL - 41 Suppl 1 N2 - To investigate the effectiveness and the mechanisms of an orthostatic self-training program for the prevention of neurocardiogenic syncope, 28 patients were treated with an orthostatic self-training program. Syncope was induced by head-up tilt testing (+ 80 degrees for 30 min) in all patients. The onset time of the tilt-induced syncope was 14 +/- 7 min following placement in the upright position. The orthostatic self-training program included standing against a wall without moving twice a day every day for a planned duration of up to 30 min at home. The head-up tilt response was re-evaluated after 24 +/- 6 days based on results of the self-training. In 12 of the 28 patients, the sympathovagal balance was also determined during the head-up tilt test before and after the training with power spectral analysis of heart rate variability using a maximal entropy method. Syncope was not observed in any patient after the training. Although the low frequency/high frequency ratio in the supine position was not different before and after the training, the ratio after 3 min in the upright position after the training decreased significantly compared with that before the training. High-frequency components in the supine and upright positions were not different before and after the training. We concluded that orthostatic self-training significantly improved symptoms in patients with tilt-induced neurocardiogenic syncope. Decreased sympathetic activity in the early stage of the upright position period may play an important role in the mechanisms of this therapy. SN - 0160-2446 UR - https://www.unboundmedicine.com/medline/citation/12688401/Effects_of_orthostatic_self_training_on_head_up_tilt_testing_and_autonomic_balance_in_patients_with_neurocardiogenic_syncope_ DB - PRIME DP - Unbound Medicine ER -