Early Cerebral Hypoperfusion in Patients with Orthostatic Intolerance Without Tachycardia During Head-Up Tilt Test is Independent of Vasovagal Response

Background: Cerebral hypoperfusion before syncope has been shown in patients with chronic orthostatic intolerance (OI) without tachycardia, but it is unknown if an initial decrease of cerebral blood flow velocity (CBFv) could be related to the vasovagal response (VVR) to head-up tilt test (HUTT). Ob...

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Autores principales:	J. Antonio González-Hermosillo, Alan Rubio-Vega, Karla A. F. González-Olvera, Manuel Sierra-Beltrán, Andrei Kostine, Claudia Lerma
Formato:	article
Lenguaje:	EN
Publicado:	Permanyer 2021
Materias:	Orthostatic intolerance. Reflex syncope. Cerebral hypoperfusion. Head-up tilt test. Internal medicine RC31-1245
Acceso en línea:	https://doaj.org/article/f146be76a79343a19362a1055d6b3229
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spelling	oai:doaj.org-article:f146be76a79343a19362a1055d6b32292021-11-09T14:24:47ZEarly Cerebral Hypoperfusion in Patients with Orthostatic Intolerance Without Tachycardia During Head-Up Tilt Test is Independent of Vasovagal Response10.24875/RIC.210001990034-83762564-8896https://doaj.org/article/f146be76a79343a19362a1055d6b32292021-01-01T00:00:00Zhttps://www.clinicalandtranslationalinvestigation.com/frame_esp.php?id=382https://doaj.org/toc/0034-8376https://doaj.org/toc/2564-8896Background: Cerebral hypoperfusion before syncope has been shown in patients with chronic orthostatic intolerance (OI) without tachycardia, but it is unknown if an initial decrease of cerebral blood flow velocity (CBFv) could be related to the vasovagal response (VVR) to head-up tilt test (HUTT). Objective: The objective of the study was to compare cardiovascular, cerebrovascular, and autonomic variables during HUTT in OI patients with or without a VVR. Methods: We included 74 subjects (58% female, mean age 33 ± 12 years) who underwent a 30-min HUTT and were divided into three groups: OI with VVR positive (VVR+), OI without VVR negative (VVR−), and asymptomatic healthy subjects with negative HUTT (control group). Cardiovascular, cerebrovascular, and autonomic variables were assessed beat-to-beat during HUTT with a Task Force monitor and a trans-cranial Doppler. Mean values were evaluated at baseline and throughout the first 10 min of tilting. Results: Cardiovascular variables were similar in the three groups. Systolic, diastolic, and mean CBFv were similar in VVR+ and VVR−, but both groups had lower CBFv than the control group. Systolic and diastolic CBFv decreased from baseline since min 1 in VVR+ and VVR− and since min 5 in the control group. The mean CBFv had a significant decrease since min 1 compared to baseline in all groups. Spectral indices of heart rate and blood pressure variability showed a similar autonomic response to HUTT in all groups. Conclusion: Patients with chronic OI without tachycardia have early postural cerebral hypoperfusion, regardless of the VVR during HUTT. J. Antonio González-HermosilloAlan Rubio-VegaKarla A. F. González-OlveraManuel Sierra-BeltránAndrei KostineClaudia LermaPermanyerarticleOrthostatic intolerance. Reflex syncope. Cerebral hypoperfusion. Head-up tilt test.Internal medicineRC31-1245ENRevista de Investigación Clínica, Vol 73, Iss 6 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Orthostatic intolerance. Reflex syncope. Cerebral hypoperfusion. Head-up tilt test. Internal medicine RC31-1245
spellingShingle	Orthostatic intolerance. Reflex syncope. Cerebral hypoperfusion. Head-up tilt test. Internal medicine RC31-1245 J. Antonio González-Hermosillo Alan Rubio-Vega Karla A. F. González-Olvera Manuel Sierra-Beltrán Andrei Kostine Claudia Lerma Early Cerebral Hypoperfusion in Patients with Orthostatic Intolerance Without Tachycardia During Head-Up Tilt Test is Independent of Vasovagal Response
description	Background: Cerebral hypoperfusion before syncope has been shown in patients with chronic orthostatic intolerance (OI) without tachycardia, but it is unknown if an initial decrease of cerebral blood flow velocity (CBFv) could be related to the vasovagal response (VVR) to head-up tilt test (HUTT). Objective: The objective of the study was to compare cardiovascular, cerebrovascular, and autonomic variables during HUTT in OI patients with or without a VVR. Methods: We included 74 subjects (58% female, mean age 33 ± 12 years) who underwent a 30-min HUTT and were divided into three groups: OI with VVR positive (VVR+), OI without VVR negative (VVR−), and asymptomatic healthy subjects with negative HUTT (control group). Cardiovascular, cerebrovascular, and autonomic variables were assessed beat-to-beat during HUTT with a Task Force monitor and a trans-cranial Doppler. Mean values were evaluated at baseline and throughout the first 10 min of tilting. Results: Cardiovascular variables were similar in the three groups. Systolic, diastolic, and mean CBFv were similar in VVR+ and VVR−, but both groups had lower CBFv than the control group. Systolic and diastolic CBFv decreased from baseline since min 1 in VVR+ and VVR− and since min 5 in the control group. The mean CBFv had a significant decrease since min 1 compared to baseline in all groups. Spectral indices of heart rate and blood pressure variability showed a similar autonomic response to HUTT in all groups. Conclusion: Patients with chronic OI without tachycardia have early postural cerebral hypoperfusion, regardless of the VVR during HUTT.
format	article
author	J. Antonio González-Hermosillo Alan Rubio-Vega Karla A. F. González-Olvera Manuel Sierra-Beltrán Andrei Kostine Claudia Lerma
author_facet	J. Antonio González-Hermosillo Alan Rubio-Vega Karla A. F. González-Olvera Manuel Sierra-Beltrán Andrei Kostine Claudia Lerma
author_sort	J. Antonio González-Hermosillo
title	Early Cerebral Hypoperfusion in Patients with Orthostatic Intolerance Without Tachycardia During Head-Up Tilt Test is Independent of Vasovagal Response
title_short	Early Cerebral Hypoperfusion in Patients with Orthostatic Intolerance Without Tachycardia During Head-Up Tilt Test is Independent of Vasovagal Response
title_full	Early Cerebral Hypoperfusion in Patients with Orthostatic Intolerance Without Tachycardia During Head-Up Tilt Test is Independent of Vasovagal Response
title_fullStr	Early Cerebral Hypoperfusion in Patients with Orthostatic Intolerance Without Tachycardia During Head-Up Tilt Test is Independent of Vasovagal Response
title_full_unstemmed	Early Cerebral Hypoperfusion in Patients with Orthostatic Intolerance Without Tachycardia During Head-Up Tilt Test is Independent of Vasovagal Response
title_sort	early cerebral hypoperfusion in patients with orthostatic intolerance without tachycardia during head-up tilt test is independent of vasovagal response
publisher	Permanyer
publishDate	2021
url	https://doaj.org/article/f146be76a79343a19362a1055d6b3229
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Early Cerebral Hypoperfusion in Patients with Orthostatic Intolerance Without Tachycardia During Head-Up Tilt Test is Independent of Vasovagal Response

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