Tags

Type your tag names separated by a space and hit enter

[The re-evaluation of the vasodepressive component in the carotid sinus syndrome].
G Ital Cardiol. 1995 Mar; 25(3):327-33.GI

Abstract

BACKGROUND

The evaluation of the vasodepressor (VD) reflex of the carotid sinus syndrome is usually inaccurate, due to the difficulty in blood pressure measurement.

AIM

To study the VD reflex with a beat-to-beat not invasive technique.

METHODS

We investigated 68 patients (49 males, 19 females; mean age 70 +/- 11 years) affected by carotid sinus syndrome: cardioinhibitory (CI) form was present in 47 patients, mixed (M) form in 10 patients and VD form in 11 patients. The control group consisted of 9 patients (6 male, mean age 71 +/- 8 years) affected by third degree atrioventricular block who had received the implant of a permanent pacemaker and were pacemaker-dependent with a prolonged asystole at time of temporary inhibition of the pacemaker itself. The study of the VD reflex was performed in the supine position; beat-to-beat arterial systolic pressure was monitored by a photoplethysmographic method using a finger cuff (Finapres technique).

RESULTS

In all the patients the carotid sinus massage caused a marked fall in systolic blood pressure which was greatest at the end of the massage: from 143 +/- 25 mm Hg to 74 +/- 20 mm Hg in the patients with CI form, from 144 +/- 14 mm Hg to 76 +/- 18 mm Hg in those with M form and from 125 +/- 26 mm Hg to 65 +/- 13 mm Hg in those with VD form. A decrease in systolic blood pressure > or = 50 mm Hg occurred in 84% of cases. Afterwards, the patients with CI form had a progressive increase of systolic blood pressure that reached the initial value after a mean of 27 seconds. In the patients with VD form systolic blood pressure was significantly (p < or = 0.5) lower than that observed in all the other groups, beginning from the third second after the end of the massage; mean systolic blood pressure value remained significantly lower than the initial value for more than 27 seconds. The patients with M form showed an intermediate pattern. Also control group patients showed a fall in systolic blood pressure immediately after pacemaker inhibition (from 152 +/- 29 mm Hg to 87 +/- 25 mm Hg) that was of similar extent than that observed in carotid sinus syndrome patients, but pressure returned to initial value within 9 seconds.

CONCLUSIONS

An important VD reflex is present in most patients with carotid sinus syndrome. It lasts more than the CI reflex and it persists for several seconds after the end of the massage. The initial fall of systolic blood pressure is of similar extent in all the forms of carotid sinus syndrome, but the patients with the VD form are characterized by a longer duration and greater entity of the decrease. These results point out the importance of the VD reflex in patients with the carotid sinus syndrome.

Authors+Show Affiliations

Gaggioli G
Servicio di Cardiologia, Ospedale di Lavagna.
Brignole M
No affiliation info available
Menozzi C
No affiliation info available
Oddone D
No affiliation info available
Gianfranchi L
No affiliation info available
Bollini R
No affiliation info available
Bottoni N
No affiliation info available
Lolli G
No affiliation info available

MeSH

AgedAged, 80 and overAnalysis of VarianceBaroreflexBlood PressureCarotid Artery DiseasesCarotid SinusFemaleHumansMaleMassageMiddle AgedPhotoplethysmographySyncopeSyndrome

Pub Type(s)

Comparative Study
English Abstract
Journal Article

Language

ita

PubMed ID

7642038

Citation

Gaggioli, G, et al. "[The Re-evaluation of the Vasodepressive Component in the Carotid Sinus Syndrome]." Giornale Italiano Di Cardiologia, vol. 25, no. 3, 1995, pp. 327-33.
Gaggioli G, Brignole M, Menozzi C, et al. [The re-evaluation of the vasodepressive component in the carotid sinus syndrome]. G Ital Cardiol. 1995;25(3):327-33.
Gaggioli, G., Brignole, M., Menozzi, C., Oddone, D., Gianfranchi, L., Bollini, R., Bottoni, N., & Lolli, G. (1995). [The re-evaluation of the vasodepressive component in the carotid sinus syndrome]. Giornale Italiano Di Cardiologia, 25(3), 327-33.
Gaggioli G, et al. [The Re-evaluation of the Vasodepressive Component in the Carotid Sinus Syndrome]. G Ital Cardiol. 1995;25(3):327-33. PubMed PMID: 7642038.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [The re-evaluation of the vasodepressive component in the carotid sinus syndrome]. AU - Gaggioli,G, AU - Brignole,M, AU - Menozzi,C, AU - Oddone,D, AU - Gianfranchi,L, AU - Bollini,R, AU - Bottoni,N, AU - Lolli,G, PY - 1995/3/1/pubmed PY - 1995/3/1/medline PY - 1995/3/1/entrez SP - 327 EP - 33 JF - Giornale italiano di cardiologia JO - G Ital Cardiol VL - 25 IS - 3 N2 - BACKGROUND: The evaluation of the vasodepressor (VD) reflex of the carotid sinus syndrome is usually inaccurate, due to the difficulty in blood pressure measurement. AIM: To study the VD reflex with a beat-to-beat not invasive technique. METHODS: We investigated 68 patients (49 males, 19 females; mean age 70 +/- 11 years) affected by carotid sinus syndrome: cardioinhibitory (CI) form was present in 47 patients, mixed (M) form in 10 patients and VD form in 11 patients. The control group consisted of 9 patients (6 male, mean age 71 +/- 8 years) affected by third degree atrioventricular block who had received the implant of a permanent pacemaker and were pacemaker-dependent with a prolonged asystole at time of temporary inhibition of the pacemaker itself. The study of the VD reflex was performed in the supine position; beat-to-beat arterial systolic pressure was monitored by a photoplethysmographic method using a finger cuff (Finapres technique). RESULTS: In all the patients the carotid sinus massage caused a marked fall in systolic blood pressure which was greatest at the end of the massage: from 143 +/- 25 mm Hg to 74 +/- 20 mm Hg in the patients with CI form, from 144 +/- 14 mm Hg to 76 +/- 18 mm Hg in those with M form and from 125 +/- 26 mm Hg to 65 +/- 13 mm Hg in those with VD form. A decrease in systolic blood pressure > or = 50 mm Hg occurred in 84% of cases. Afterwards, the patients with CI form had a progressive increase of systolic blood pressure that reached the initial value after a mean of 27 seconds. In the patients with VD form systolic blood pressure was significantly (p < or = 0.5) lower than that observed in all the other groups, beginning from the third second after the end of the massage; mean systolic blood pressure value remained significantly lower than the initial value for more than 27 seconds. The patients with M form showed an intermediate pattern. Also control group patients showed a fall in systolic blood pressure immediately after pacemaker inhibition (from 152 +/- 29 mm Hg to 87 +/- 25 mm Hg) that was of similar extent than that observed in carotid sinus syndrome patients, but pressure returned to initial value within 9 seconds. CONCLUSIONS: An important VD reflex is present in most patients with carotid sinus syndrome. It lasts more than the CI reflex and it persists for several seconds after the end of the massage. The initial fall of systolic blood pressure is of similar extent in all the forms of carotid sinus syndrome, but the patients with the VD form are characterized by a longer duration and greater entity of the decrease. These results point out the importance of the VD reflex in patients with the carotid sinus syndrome. SN - 0046-5968 UR - https://www.unboundmedicine.com/medline/citation/7642038/[The_re_evaluation_of_the_vasodepressive_component_in_the_carotid_sinus_syndrome]_ DB - PRIME DP - Unbound Medicine ER -