Tags

Type your tag names separated by a space and hit enter

Heart rate and blood pressure variability in subjects with vasovagal syncope.
Clin Sci (Lond). 2004 Jul; 107(1):55-61.CS

Abstract

Autonomic nervous system control in subjects with vasovagal syncope is controversial. In the present study, we used short-term spectral analysis to evaluate autonomic control in subjects with recurrent vasovagal syncope. We assessed the ability of spectral indices of HR (heart rate) variability to predict tilt-test responses. A series of 47 outpatients with recurrent vasovagal syncope and with positive responses to head-up tilt testing underwent a further study of RR variability during controlled breathing at rest and during tilt testing. During controlled breathing, RR interval variability of total power (TP(RR); P<0.001), low-frequency power (LF(RR); P<0.05), high-frequency power (HF(RR); P<0.001) and HF expressed in normalized units (HFnu(RR); P<0.001) were all higher, and LF expressed in normalized units (LFnu(RR)) and LF/HF ratio were lower in subjects with vasovagal syncope than in controls (P<0.001). To assess the ability of spectral components of RR variability to predict tilt-test responses, we prospectively studied 109 subjects with recurrent vasovagal syncope. The two normalized measures, HFnu(RR) and LFnu(RR), determined during controlled breathing alone predicted a positive tilt-test response (sensitivity, 76%; specificity, 99%; positive predictive value, 96%; and negative predictive value, 90%). During tilting, subjects with vasovagal syncope had lower SBP (systolic blood pressure; P<0.05), LF component of peak SBP variability (LF(SBP)) and LFnu(RR) than controls, and higher TP(RR), HF(RR), HFnu(RR) and alpha HF (P<0.001). These spectral data indicate that vagal sinus modulation is increased at rest in subjects with vasovagal syncope. Spectral analysis of RR variability during controlled breathing, a procedure that predicts tilt-test responses, could be a useful guide in choosing the method of tilt testing.

Authors+Show Affiliations

Piccirillo G
Dipartimento di Scienze dell'Invecchiamento, Policlinico Umberto I, Università La Sapienza, 00161 Rome, Italy. gianfranco.piccirillo@uniroma1.it
Naso C
No affiliation info available
Moisè A
No affiliation info available
Lionetti M
No affiliation info available
Nocco M
No affiliation info available
Di Carlo S
No affiliation info available
De Laurentis T
No affiliation info available
Magrì D
No affiliation info available
Cacciafesta M
No affiliation info available
Marigliano V
No affiliation info available

MeSH

AdultAnthropometryBlood PressureFemaleHeart RateHumansMaleMiddle AgedProspective StudiesRecurrenceRespiratory MechanicsSignal Processing, Computer-AssistedSyncope, VasovagalTilt-Table Test

Pub Type(s)

Journal Article

Language

eng

PubMed ID

14982493

Citation

Piccirillo, Gianfranco, et al. "Heart Rate and Blood Pressure Variability in Subjects With Vasovagal Syncope." Clinical Science (London, England : 1979), vol. 107, no. 1, 2004, pp. 55-61.
Piccirillo G, Naso C, Moisè A, et al. Heart rate and blood pressure variability in subjects with vasovagal syncope. Clin Sci (Lond). 2004;107(1):55-61.
Piccirillo, G., Naso, C., Moisè, A., Lionetti, M., Nocco, M., Di Carlo, S., De Laurentis, T., Magrì, D., Cacciafesta, M., & Marigliano, V. (2004). Heart rate and blood pressure variability in subjects with vasovagal syncope. Clinical Science (London, England : 1979), 107(1), 55-61.
Piccirillo G, et al. Heart Rate and Blood Pressure Variability in Subjects With Vasovagal Syncope. Clin Sci (Lond). 2004;107(1):55-61. PubMed PMID: 14982493.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Heart rate and blood pressure variability in subjects with vasovagal syncope. AU - Piccirillo,Gianfranco, AU - Naso,Camilla, AU - Moisè,Antonio, AU - Lionetti,Marco, AU - Nocco,Marialuce, AU - Di Carlo,Silvia, AU - De Laurentis,Tiziana, AU - Magrì,Damiano, AU - Cacciafesta,Mauro, AU - Marigliano,Vincenzo, PY - 2004/02/25/accepted PY - 2004/01/29/revised PY - 2003/10/06/received PY - 2004/2/26/pubmed PY - 2004/8/3/medline PY - 2004/2/26/entrez SP - 55 EP - 61 JF - Clinical science (London, England : 1979) JO - Clin Sci (Lond) VL - 107 IS - 1 N2 - Autonomic nervous system control in subjects with vasovagal syncope is controversial. In the present study, we used short-term spectral analysis to evaluate autonomic control in subjects with recurrent vasovagal syncope. We assessed the ability of spectral indices of HR (heart rate) variability to predict tilt-test responses. A series of 47 outpatients with recurrent vasovagal syncope and with positive responses to head-up tilt testing underwent a further study of RR variability during controlled breathing at rest and during tilt testing. During controlled breathing, RR interval variability of total power (TP(RR); P<0.001), low-frequency power (LF(RR); P<0.05), high-frequency power (HF(RR); P<0.001) and HF expressed in normalized units (HFnu(RR); P<0.001) were all higher, and LF expressed in normalized units (LFnu(RR)) and LF/HF ratio were lower in subjects with vasovagal syncope than in controls (P<0.001). To assess the ability of spectral components of RR variability to predict tilt-test responses, we prospectively studied 109 subjects with recurrent vasovagal syncope. The two normalized measures, HFnu(RR) and LFnu(RR), determined during controlled breathing alone predicted a positive tilt-test response (sensitivity, 76%; specificity, 99%; positive predictive value, 96%; and negative predictive value, 90%). During tilting, subjects with vasovagal syncope had lower SBP (systolic blood pressure; P<0.05), LF component of peak SBP variability (LF(SBP)) and LFnu(RR) than controls, and higher TP(RR), HF(RR), HFnu(RR) and alpha HF (P<0.001). These spectral data indicate that vagal sinus modulation is increased at rest in subjects with vasovagal syncope. Spectral analysis of RR variability during controlled breathing, a procedure that predicts tilt-test responses, could be a useful guide in choosing the method of tilt testing. SN - 0143-5221 UR - https://www.unboundmedicine.com/medline/citation/14982493/Heart_rate_and_blood_pressure_variability_in_subjects_with_vasovagal_syncope_ DB - PRIME DP - Unbound Medicine ER -