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Mayer wave activity in vasodepressor carotid sinus hypersensitivity.
Europace. 2010 Feb; 12(2):247-53.E

Abstract

AIMS

Mayer waves are low frequency blood pressure waves, whose modulation involves central/peripheral baroreflex pathways. Although vasodepressor carotid sinus hypersensitivity (VDCSH) is a common hypotensive disorder in ageing, the mechanism of VDCSH is unknown. We hypothesize that VDCSH is due to impaired baroreflex function and that Mayer wave amplitude and oscillation frequency are therefore altered.

METHODS AND RESULTS

Ten minutes ECG and continuous beat-to-beat blood pressure (TNO Finapres(c)) recordings were taken in supine position. Blood pressure variance, spectral power (0.04-0.15 Hz) and centre of frequency was examined across a number of frequency bands. Vasodepressor carotid sinus hypersensitivity was defined as 50 mmHg drop in systolic blood pressure (SBP) during carotid sinus massage. Syncope facility was used in this study. Twelve patients with VDCSH median age 72 range (50-92) were compared with 36 case-controls median age 78 range (48-88). Diastolic blood pressure variability (median SD) was significantly higher in the VDCSH 6.6 (1.9-12.9) mmHg compared with controls 4.0 (1.7-9.5) mmHg; P < 0.05. Mean arterial blood pressure (MAP) variability (median SD) was significantly higher in the VDCSH 6.6 (2.9-10.1) mmHg compared with controls 4.6 (2.5-9.1) mmHg; P < 0.05. Low frequency Mayer wave activity in MAP in VDCSH compared with controls was increased at 0.06 Hz [controls -21.7 mmHg(2)/Hz (IQR: 30.8); VDCSH -31.5 mmHg(2)/Hz (IQR: 72.0) P < 0.05] and at 0.1 Hz [controls -4.9 mmHg(2)/Hz (IQR: 9.4); VDCSH -11.5 mmHg(2)/Hz (IQR: 12.9) P < 0.1]. High frequency blood pressure fluctuations were significantly increased at 0.3 Hz in VDCSH group in SBP [controls -4.1 mmHg(2)/Hz (IQR: 10.4); VDCSH -17.4 mmHg(2)/Hz (IQR: 47.9) P < 0.05] and MAP records [controls -32.5 mmHg(2)/Hz (IQR: 76.9); VDCSH -64.6 mmHg(2)/Hz (IQR: 59.8) P < 0.01].

CONCLUSION

Blood pressure variability in particular activity at Mayer wave frequencies was higher in VDCSH. Future work will investigate this approach as a basis for diagnosis of VDCSH, with implications for syncope and falls management.

Links

Publisher Full Text (DOI)

Authors+Show Affiliations

Finucane C
Department of Medical Physics and Bioengineering, St James's Hospital, Dublin 8, Ireland. cfinucane@stjames.ie
Boyle G
No affiliation info available
Fan CW
No affiliation info available
Hade D
No affiliation info available
Byrne L
No affiliation info available
Kenny RA
No affiliation info available

MeSH

AgedAged, 80 and overBlood Flow VelocityBlood PressureCardiovascular Physiological PhenomenaCarotid SinusCase-Control StudiesFemaleHeart RateHumansHypotensionMaleMiddle AgedProspective StudiesSyncopeSyncope, Vasovagal

Pub Type(s)

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

Language

eng

PubMed ID

20089753

Citation

Finucane, Ciarán, et al. "Mayer Wave Activity in Vasodepressor Carotid Sinus Hypersensitivity." Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups On Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology, vol. 12, no. 2, 2010, pp. 247-53.
Finucane C, Boyle G, Fan CW, et al. Mayer wave activity in vasodepressor carotid sinus hypersensitivity. Europace. 2010;12(2):247-53.
Finucane, C., Boyle, G., Fan, C. W., Hade, D., Byrne, L., & Kenny, R. A. (2010). Mayer wave activity in vasodepressor carotid sinus hypersensitivity. Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups On Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology, 12(2), 247-53. https://doi.org/10.1093/europace/eup385
Finucane C, et al. Mayer Wave Activity in Vasodepressor Carotid Sinus Hypersensitivity. Europace. 2010;12(2):247-53. PubMed PMID: 20089753.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Mayer wave activity in vasodepressor carotid sinus hypersensitivity. AU - Finucane,Ciarán, AU - Boyle,Gerard, AU - Fan,Chie Wei, AU - Hade,Dymphna, AU - Byrne,Lisa, AU - Kenny,Rose Anne, PY - 2010/1/22/entrez PY - 2010/1/22/pubmed PY - 2010/6/16/medline SP - 247 EP - 53 JF - Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology JO - Europace VL - 12 IS - 2 N2 - AIMS: Mayer waves are low frequency blood pressure waves, whose modulation involves central/peripheral baroreflex pathways. Although vasodepressor carotid sinus hypersensitivity (VDCSH) is a common hypotensive disorder in ageing, the mechanism of VDCSH is unknown. We hypothesize that VDCSH is due to impaired baroreflex function and that Mayer wave amplitude and oscillation frequency are therefore altered. METHODS AND RESULTS: Ten minutes ECG and continuous beat-to-beat blood pressure (TNO Finapres(c)) recordings were taken in supine position. Blood pressure variance, spectral power (0.04-0.15 Hz) and centre of frequency was examined across a number of frequency bands. Vasodepressor carotid sinus hypersensitivity was defined as 50 mmHg drop in systolic blood pressure (SBP) during carotid sinus massage. Syncope facility was used in this study. Twelve patients with VDCSH median age 72 range (50-92) were compared with 36 case-controls median age 78 range (48-88). Diastolic blood pressure variability (median SD) was significantly higher in the VDCSH 6.6 (1.9-12.9) mmHg compared with controls 4.0 (1.7-9.5) mmHg; P < 0.05. Mean arterial blood pressure (MAP) variability (median SD) was significantly higher in the VDCSH 6.6 (2.9-10.1) mmHg compared with controls 4.6 (2.5-9.1) mmHg; P < 0.05. Low frequency Mayer wave activity in MAP in VDCSH compared with controls was increased at 0.06 Hz [controls -21.7 mmHg(2)/Hz (IQR: 30.8); VDCSH -31.5 mmHg(2)/Hz (IQR: 72.0) P < 0.05] and at 0.1 Hz [controls -4.9 mmHg(2)/Hz (IQR: 9.4); VDCSH -11.5 mmHg(2)/Hz (IQR: 12.9) P < 0.1]. High frequency blood pressure fluctuations were significantly increased at 0.3 Hz in VDCSH group in SBP [controls -4.1 mmHg(2)/Hz (IQR: 10.4); VDCSH -17.4 mmHg(2)/Hz (IQR: 47.9) P < 0.05] and MAP records [controls -32.5 mmHg(2)/Hz (IQR: 76.9); VDCSH -64.6 mmHg(2)/Hz (IQR: 59.8) P < 0.01]. CONCLUSION: Blood pressure variability in particular activity at Mayer wave frequencies was higher in VDCSH. Future work will investigate this approach as a basis for diagnosis of VDCSH, with implications for syncope and falls management. SN - 1532-2092 UR - https://www.unboundmedicine.com/medline/citation/20089753/Mayer_wave_activity_in_vasodepressor_carotid_sinus_hypersensitivity_ DB - PRIME DP - Unbound Medicine ER -