High Skin Sympathetic Nerve Activity in Patients with Recurrent Syncope
(1) Background: The autonomic imbalance plays a role in vasovagal syncope (VVS) diagnosed by head-up tilting test (HUT). neuECG is a new method of recording skin electrical signals to simultaneously analyze skin sympathetic nerve activity (SKNA) and electrocardiogram. We hypothesize that SKNA is hig...
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MDPI AG
2021
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oai:doaj.org-article:fa03d66b0d774756b1647d8bc860fd082021-11-25T18:06:45ZHigh Skin Sympathetic Nerve Activity in Patients with Recurrent Syncope10.3390/jpm111110532075-4426https://doaj.org/article/fa03d66b0d774756b1647d8bc860fd082021-10-01T00:00:00Zhttps://www.mdpi.com/2075-4426/11/11/1053https://doaj.org/toc/2075-4426(1) Background: The autonomic imbalance plays a role in vasovagal syncope (VVS) diagnosed by head-up tilting test (HUT). neuECG is a new method of recording skin electrical signals to simultaneously analyze skin sympathetic nerve activity (SKNA) and electrocardiogram. We hypothesize that SKNA is higher in subjects with tilt-positive than tilt-negative and the SKNA surges before syncope. (2) Methods: We recorded neuECG in 41 subjects who received HUT (according to the “Italian protocol”), including rest, tilt-up, provocation and recovery phases. Data were analyzed to determine the average SKNA (aSKNA, μV) per digitized sample. Electrocardiogram was used to calculate standard deviation of normal-to-normal beat intervals (SDNN). The “SKNA-SDNN index” was calculated by rest aSKNA multiplied by the ratio of tilt-up to rest SDNN. (3) Results: 16 of 41 (39%) subjects developed syncope. The aSKNA at rest phase is significantly higher in the tilt-positive (1.21 ± 0.27 µV) than tilt-negative subjects (1.02 ± 0.29 µV) (<i>p</i> = 0.034). There are significant surges and withdraw of aSKNA 30 s before and after syncope (both <i>p</i> ≤ 0.006). SKNA-SDNN index is able to predict syncope (<i>p</i> < 0.001). (4) Conclusion: Higher SKNA at rest phase is associated with positive HUT. The SKNA-SDNN index is a novel marker to predict syncope during HUT.Tien-Chi HuangNai-Yu ChiChih-Sung LanChang-Jen ChenShih-Jie JhuoTsung-Han LinYi-Hsueh LiuLi-Fang ChouChien-Wei ChangWei-Sheng LiaoPei-Heng KaoPo-Chao HsuChee-Siong LeeYi-Hsiung LinHsiang-Chun LeeYe-Hsu LuHsueh-Wei YenTsung-Hsien LinHo-Ming SuWen-Ter LaiWei-Chung TsaiShien-Fong LinChien-Hung LeeMDPI AGarticleskin sympathetic nerve activityvasovagal syncopehead-up tilting testheart rate variabilityMedicineRENJournal of Personalized Medicine, Vol 11, Iss 1053, p 1053 (2021) |
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EN |
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skin sympathetic nerve activity vasovagal syncope head-up tilting test heart rate variability Medicine R |
| spellingShingle |
skin sympathetic nerve activity vasovagal syncope head-up tilting test heart rate variability Medicine R Tien-Chi Huang Nai-Yu Chi Chih-Sung Lan Chang-Jen Chen Shih-Jie Jhuo Tsung-Han Lin Yi-Hsueh Liu Li-Fang Chou Chien-Wei Chang Wei-Sheng Liao Pei-Heng Kao Po-Chao Hsu Chee-Siong Lee Yi-Hsiung Lin Hsiang-Chun Lee Ye-Hsu Lu Hsueh-Wei Yen Tsung-Hsien Lin Ho-Ming Su Wen-Ter Lai Wei-Chung Tsai Shien-Fong Lin Chien-Hung Lee High Skin Sympathetic Nerve Activity in Patients with Recurrent Syncope |
| description |
(1) Background: The autonomic imbalance plays a role in vasovagal syncope (VVS) diagnosed by head-up tilting test (HUT). neuECG is a new method of recording skin electrical signals to simultaneously analyze skin sympathetic nerve activity (SKNA) and electrocardiogram. We hypothesize that SKNA is higher in subjects with tilt-positive than tilt-negative and the SKNA surges before syncope. (2) Methods: We recorded neuECG in 41 subjects who received HUT (according to the “Italian protocol”), including rest, tilt-up, provocation and recovery phases. Data were analyzed to determine the average SKNA (aSKNA, μV) per digitized sample. Electrocardiogram was used to calculate standard deviation of normal-to-normal beat intervals (SDNN). The “SKNA-SDNN index” was calculated by rest aSKNA multiplied by the ratio of tilt-up to rest SDNN. (3) Results: 16 of 41 (39%) subjects developed syncope. The aSKNA at rest phase is significantly higher in the tilt-positive (1.21 ± 0.27 µV) than tilt-negative subjects (1.02 ± 0.29 µV) (<i>p</i> = 0.034). There are significant surges and withdraw of aSKNA 30 s before and after syncope (both <i>p</i> ≤ 0.006). SKNA-SDNN index is able to predict syncope (<i>p</i> < 0.001). (4) Conclusion: Higher SKNA at rest phase is associated with positive HUT. The SKNA-SDNN index is a novel marker to predict syncope during HUT. |
| format |
article |
| author |
Tien-Chi Huang Nai-Yu Chi Chih-Sung Lan Chang-Jen Chen Shih-Jie Jhuo Tsung-Han Lin Yi-Hsueh Liu Li-Fang Chou Chien-Wei Chang Wei-Sheng Liao Pei-Heng Kao Po-Chao Hsu Chee-Siong Lee Yi-Hsiung Lin Hsiang-Chun Lee Ye-Hsu Lu Hsueh-Wei Yen Tsung-Hsien Lin Ho-Ming Su Wen-Ter Lai Wei-Chung Tsai Shien-Fong Lin Chien-Hung Lee |
| author_facet |
Tien-Chi Huang Nai-Yu Chi Chih-Sung Lan Chang-Jen Chen Shih-Jie Jhuo Tsung-Han Lin Yi-Hsueh Liu Li-Fang Chou Chien-Wei Chang Wei-Sheng Liao Pei-Heng Kao Po-Chao Hsu Chee-Siong Lee Yi-Hsiung Lin Hsiang-Chun Lee Ye-Hsu Lu Hsueh-Wei Yen Tsung-Hsien Lin Ho-Ming Su Wen-Ter Lai Wei-Chung Tsai Shien-Fong Lin Chien-Hung Lee |
| author_sort |
Tien-Chi Huang |
| title |
High Skin Sympathetic Nerve Activity in Patients with Recurrent Syncope |
| title_short |
High Skin Sympathetic Nerve Activity in Patients with Recurrent Syncope |
| title_full |
High Skin Sympathetic Nerve Activity in Patients with Recurrent Syncope |
| title_fullStr |
High Skin Sympathetic Nerve Activity in Patients with Recurrent Syncope |
| title_full_unstemmed |
High Skin Sympathetic Nerve Activity in Patients with Recurrent Syncope |
| title_sort |
high skin sympathetic nerve activity in patients with recurrent syncope |
| publisher |
MDPI AG |
| publishDate |
2021 |
| url |
https://doaj.org/article/fa03d66b0d774756b1647d8bc860fd08 |
| work_keys_str_mv |
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