- MeSH
- Humans MeSH
- Heart Diseases MeSH
- Tilt-Table Test methods MeSH
- Exercise Test * methods MeSH
- Check Tag
- Humans MeSH
- MeSH
- Diagnostic Techniques, Cardiovascular * MeSH
- Electrocardiography MeSH
- Ergometry methods MeSH
- Heart Function Tests classification methods MeSH
- Myocardial Ischemia diagnosis MeSH
- Cardiology * methods MeSH
- Contraindications MeSH
- Humans MeSH
- Heart Diseases diagnosis MeSH
- Tilt-Table Test methods MeSH
- Exercise Test methods MeSH
- Check Tag
- Humans MeSH
- Publication type
- Review MeSH
- MeSH
- Bradycardia diagnosis etiology prevention & control MeSH
- Diuretics adverse effects MeSH
- Hypertension diagnosis etiology physiopathology MeSH
- Hypovolemia diagnosis etiology physiopathology MeSH
- Cardiology * methods trends MeSH
- Humans MeSH
- Interdisciplinary Communication MeSH
- Postural Balance physiology MeSH
- Somatosensory Disorders * diagnosis etiology physiopathology MeSH
- Arrhythmias, Cardiac diagnosis etiology prevention & control MeSH
- Statistics as Topic MeSH
- Syncope diagnosis etiology physiopathology MeSH
- Tilt-Table Test methods instrumentation utilization MeSH
- Tendon Entrapment diagnosis etiology prevention & control MeSH
- Check Tag
- Humans MeSH
In previous studies, one of the systolic time intervals - preejection period (PEP) - was used as an index of sympathetic activity reflecting the cardiac contractility. However, PEP could be also influenced by several other cardiovascular variables including preload, afterload and diastolic blood pressure (DBP). The aim of this study was to assess the behavior of the PEP together with other potentially confounding cardiovascular system characteristics in healthy humans during mental and orthostatic stress (head-up tilt test - HUT). Forty-nine healthy volunteers (28 females, 21 males, mean age 18.6 years (SD=1.8 years)) participated in the study. We recorded finger arterial blood pressure by volume-clamp method (Finometer Pro, FMS, Netherlands), PEP, thoracic fluid content (TFC) - a measure of preload, and cardiac output (CO) by impedance cardiography (CardioScreen® 2000, Medis, Germany). Systemic vascular resistance (SVR) - a measure of afterload - was calculated as a ratio of mean arterial pressure and CO. We observed that during HUT, an expected decrease in TFC was accompanied by an increase of PEP, an increase of SVR and no significant change in DBP. During mental stress, we observed a decrease of PEP and an increase of TFC, SVR and DBP. Correlating a change in assessed measures (delta values) between mental stress and previous supine rest, we found that deltaPEP correlated negatively with deltaCO and positively with deltaSVR. In orthostasis, no significant correlation between deltaPEP and deltaDBP, deltaTFC, deltaCO, deltaMBP or deltaSVR was found. We conclude that despite an expected increase of sympathetic activity during both challenges, PEP behaved differently indicating an effect of other confounding factors. To interpret PEP values properly, we recommend simultaneously to measure other variables influencing this cardiovascular measure.
- MeSH
- Blood Pressure physiology MeSH
- Humans MeSH
- Cardiac Output physiology MeSH
- Adolescent MeSH
- Young Adult MeSH
- Stress, Psychological physiopathology psychology MeSH
- Heart Rate physiology MeSH
- Sympathetic Nervous System physiology MeSH
- Stroke Volume physiology MeSH
- Tilt-Table Test methods MeSH
- Check Tag
- Humans MeSH
- Adolescent MeSH
- Young Adult MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Keywords
- head-up tilt table test (HUTT), hodnocení zátěžového testu,
- MeSH
- Medical History Taking MeSH
- Diagnostic Techniques and Procedures MeSH
- Ultrasonography, Doppler, Duplex * methods utilization MeSH
- Echocardiography methods drug effects utilization MeSH
- Electrocardiography methods drug effects utilization MeSH
- Physical Examination MeSH
- Humans MeSH
- Heart Diseases diagnosis complications prevention & control MeSH
- Statistics as Topic MeSH
- Syncope * diagnosis etiology complications MeSH
- Tilt-Table Test * methods trends utilization MeSH
- Exercise Test methods utilization MeSH
- Check Tag
- Humans MeSH
An association between the CSF chromogranin A (CgA) and orthostatic blood pressure changes was investigated in 20 patients in the early stage of Parkinson disease (PD). There was a positive correlation between the CSF CgA and diastolic blood pressure change, when CSF CgA levels were lower in patients with orthostatic hypotension (OH). Decreased CSF CgA may be useful in predicting OH in the early stage of PD.
- MeSH
- Biomarkers MeSH
- Chromogranin A MeSH
- Middle Aged MeSH
- Humans MeSH
- Hypotension, Orthostatic diagnosis epidemiology MeSH
- Parkinson Disease diagnosis epidemiology MeSH
- Tilt-Table Test methods MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
AIMS: Orthostatic stimuli are known to elicit changes in vasoactive peptide levels. The hypothesis of no difference in adrenomedullin and/or galanin levels in patients with recurrent vasovagal syncope and healthy controls was tested in a passive 35-min head-up tilt test (HUTT). METHODS: Twenty eight persons (14 patients and 14 healthy controls) were tested in a 35-min/60° head-up tilt test with telemetry monitoring. Three blood samples were evaluated for each person during the HUTT. Plasma levels of adrenomedullin and galanin were analysed by the Kruskal-Wallis test for all sampling periods. Vagal influence was indirectly assessed by the break index. RESULTS: There were no significant differences between groups in median values for either adrenomedullin or galanin plasma levels (all 6 p-values were greater than 0.4). For adrenomedullin, no significant difference between groups was found. For galanin, the rate of change between the 1st and 2nd measurement was significantly greater for patients (P=0.04), regardless of HUTT result but between the 2(nd) and 3(rd) measurement it was insignificant (P=0.36). In the group of positive cases, the break index increased significantly (P=0.02). CONCLUSION: We confirmed that there is a different galanin secretion pattern during orthostatic provocation in patients with recurrent vasovagal syncope than healthy individuals. For adrenomedullin, no significant difference was found. A significant increment of the break index confirmed increased vagal influence in the subgroup of positive cases.
- MeSH
- Adrenomedullin blood MeSH
- Adult MeSH
- Galanin blood MeSH
- Blood Pressure physiology MeSH
- Middle Aged MeSH
- Humans MeSH
- Young Adult MeSH
- Posture * MeSH
- Heart Rate physiology MeSH
- Case-Control Studies MeSH
- Tilt-Table Test methods MeSH
- Syncope, Vasovagal blood MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Young Adult MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
Je prezentován případ třináctileté dívky s výraznou ortostatickou intolerancí, u níž byl po podrobném vyšetření diagnostikován syndrom posturální ortostatické tachykardie. Vzhledem k závažnosti obtíží bylo nutné zahájit farmakologickou léčbu. Na léčbě dochází k postupnému ústupu potíží tak, že léčba byla nakonec zcela vysazena. V diskuzi jsou ve stručnosti shrnuty nejdůležitější poznatky o ortostatické intoleranci. Podrobněji je pak pojednáno o syndromu posturální ortostatické tachykardie, jeho patogenezi, vztahu k syndromu chronické únavy a léčbě. Je prezentován případ třináctileté dívky s výraznou ortostatickou intolerancí, u níž byl po podrobném vyšetření diagnostikován syndrom posturální ortostatické tachykardie. Vzhledem k závažnosti obtíží bylo nutné zahájit farmakologickou léčbu. Na léčbě dochází k postupnému ústupu potíží tak, že léčba byla nakonec zcela vysazena. V diskuzi jsou ve stručnosti shrnuty nejdůležitější poznatky o ortostatické intoleranci. Podrobněji je pak pojednáno o syndromu posturální ortostatické tachykardie, jeho patogenezi, vztahu k syndromu chronické únavy a léčbě.
A case of 13-year old girl with severe orthostatic intolerance is presented. After careful investigation she was diagnosed with the postural orthostatic tachycardia syndrome. Because of the severity of symptoms pharmacological treatment was initiated. With the treatment the complaints gradually subsided and subsequently the medication was terminated. In the following discussion the most important aspects of the orthostatic intolerance are summarized. Postural orthostatic tachycardia syndrome, its pathogenesis, relationship with chronic fatigue syndrome and treatment are treated more in details.
- MeSH
- Fludrocortisone administration & dosage therapeutic use MeSH
- Blood Pressure MeSH
- Humans MeSH
- Midodrine administration & dosage therapeutic use MeSH
- Adolescent MeSH
- Orthostatic Intolerance diagnosis physiopathology therapy MeSH
- Heart Rate MeSH
- Fatigue Syndrome, Chronic complications MeSH
- Postural Orthostatic Tachycardia Syndrome diagnosis drug therapy physiopathology MeSH
- Syncope diagnosis etiology complications MeSH
- Tachycardia complications blood MeSH
- Tilt-Table Test methods MeSH
- Check Tag
- Humans MeSH
- Adolescent MeSH
- Female MeSH
- Publication type
- Case Reports MeSH
- MeSH
- Humans MeSH
- Tilt-Table Test methods MeSH
- Syncope, Vasovagal diagnosis physiopathology MeSH
- Check Tag
- Humans MeSH
