Reduced Systolic Volume: Main Pathophysiological Mechanism in Patients with Orthostatic Intolerance?
Autor(a) principal: | |
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Data de Publicação: | 2016 |
Outros Autores: | , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Arquivos Brasileiros de Cardiologia (Online) |
Texto Completo: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0066-782X2016004300354 |
Resumo: | Abstract Background: Orthostatic intolerance patients' pathophysiological mechanism is still obscure, contributing to the difficulty in their clinical management. Objective: To investigate hemodynamic changes during tilt test in individuals with orthostatic intolerance symptoms, including syncope or near syncope. Methods: Sixty-one patients who underwent tilt test at - 70° in the phase without vasodilators were divided into two groups. For data analysis, only the first 20 minutes of tilting were considered. Group I was made up of 33 patients who had an increase of total peripheral vascular resistance (TPVR) during orthostatic position; and Group II was made up of 28 patients with a decrease in TPVR (characterizing insufficient peripheral vascular resistance). The control group consisted of 24 healthy asymptomatic individuals. Hemodynamic parameters were obtained by a non-invasive hemodynamic monitor in three different moments (supine position, tilt 10' and tilt 20') adjusted for age. Results: In the supine position, systolic volume (SV) was significantly reduced in both Group II and I in comparison to the control group, respectively (66.4 ±14.9 ml vs. 81.8±14.8 ml vs. 101.5±24.2 ml; p<0.05). TPVR, however, was higher in Group II in comparison to Group I and controls, respectively (1750.5± 442 dyne.s/cm5 vs.1424±404 dyne.s/cm5 vs. 974.4±230 dyne.s/cm5; p<0.05). In the orthostatic position, at 10', there was repetition of findings, with lower absolute values of SV compared to controls (64.1±14.0 ml vs 65.5±11.3 ml vs 82.8±15.6 ml; p<0.05). TPVR, on the other hand, showed a relative drop in Group II, in comparison to Group I. Conclusion: Reduced SV was consistently observed in the groups of patients with orthostatic intolerance in comparison to the control group. Two different responses to tilt test were observed: one group with elevated TPVR and another with a relative drop in TPVR, possibly suggesting a more severe failure of compensation mechanisms. |
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Reduced Systolic Volume: Main Pathophysiological Mechanism in Patients with Orthostatic Intolerance?Orthostatic Intolerance/physiopathologyStroke VolumeVascular ResistancePostural Orthostatic Tachycardia Syndrome/physiopathologyAbstract Background: Orthostatic intolerance patients' pathophysiological mechanism is still obscure, contributing to the difficulty in their clinical management. Objective: To investigate hemodynamic changes during tilt test in individuals with orthostatic intolerance symptoms, including syncope or near syncope. Methods: Sixty-one patients who underwent tilt test at - 70° in the phase without vasodilators were divided into two groups. For data analysis, only the first 20 minutes of tilting were considered. Group I was made up of 33 patients who had an increase of total peripheral vascular resistance (TPVR) during orthostatic position; and Group II was made up of 28 patients with a decrease in TPVR (characterizing insufficient peripheral vascular resistance). The control group consisted of 24 healthy asymptomatic individuals. Hemodynamic parameters were obtained by a non-invasive hemodynamic monitor in three different moments (supine position, tilt 10' and tilt 20') adjusted for age. Results: In the supine position, systolic volume (SV) was significantly reduced in both Group II and I in comparison to the control group, respectively (66.4 ±14.9 ml vs. 81.8±14.8 ml vs. 101.5±24.2 ml; p<0.05). TPVR, however, was higher in Group II in comparison to Group I and controls, respectively (1750.5± 442 dyne.s/cm5 vs.1424±404 dyne.s/cm5 vs. 974.4±230 dyne.s/cm5; p<0.05). In the orthostatic position, at 10', there was repetition of findings, with lower absolute values of SV compared to controls (64.1±14.0 ml vs 65.5±11.3 ml vs 82.8±15.6 ml; p<0.05). TPVR, on the other hand, showed a relative drop in Group II, in comparison to Group I. Conclusion: Reduced SV was consistently observed in the groups of patients with orthostatic intolerance in comparison to the control group. Two different responses to tilt test were observed: one group with elevated TPVR and another with a relative drop in TPVR, possibly suggesting a more severe failure of compensation mechanisms.Sociedade Brasileira de Cardiologia - SBC2016-10-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0066-782X2016004300354Arquivos Brasileiros de Cardiologia v.107 n.4 2016reponame:Arquivos Brasileiros de Cardiologia (Online)instname:Sociedade Brasileira de Cardiologia (SBC)instacron:SBC10.5935/abc.20160135info:eu-repo/semantics/openAccessTávora-Mehta,Maria Zildany P.Mehta,NirajMagajevski,AdrianoOliveira,Larissa deMaluf,Débora Lee SmithConcato,LetíciaDoubrawa,EduardoOrtiz,Márcio RogérioCunha,Cláudio L. Pereira daeng2016-11-09T00:00:00Zoai:scielo:S0066-782X2016004300354Revistahttp://www.arquivosonline.com.br/https://old.scielo.br/oai/scielo-oai.php||arquivos@cardiol.br1678-41700066-782Xopendoar:2016-11-09T00:00Arquivos Brasileiros de Cardiologia (Online) - Sociedade Brasileira de Cardiologia (SBC)false |
dc.title.none.fl_str_mv |
Reduced Systolic Volume: Main Pathophysiological Mechanism in Patients with Orthostatic Intolerance? |
title |
Reduced Systolic Volume: Main Pathophysiological Mechanism in Patients with Orthostatic Intolerance? |
spellingShingle |
Reduced Systolic Volume: Main Pathophysiological Mechanism in Patients with Orthostatic Intolerance? Távora-Mehta,Maria Zildany P. Orthostatic Intolerance/physiopathology Stroke Volume Vascular Resistance Postural Orthostatic Tachycardia Syndrome/physiopathology |
title_short |
Reduced Systolic Volume: Main Pathophysiological Mechanism in Patients with Orthostatic Intolerance? |
title_full |
Reduced Systolic Volume: Main Pathophysiological Mechanism in Patients with Orthostatic Intolerance? |
title_fullStr |
Reduced Systolic Volume: Main Pathophysiological Mechanism in Patients with Orthostatic Intolerance? |
title_full_unstemmed |
Reduced Systolic Volume: Main Pathophysiological Mechanism in Patients with Orthostatic Intolerance? |
title_sort |
Reduced Systolic Volume: Main Pathophysiological Mechanism in Patients with Orthostatic Intolerance? |
author |
Távora-Mehta,Maria Zildany P. |
author_facet |
Távora-Mehta,Maria Zildany P. Mehta,Niraj Magajevski,Adriano Oliveira,Larissa de Maluf,Débora Lee Smith Concato,Letícia Doubrawa,Eduardo Ortiz,Márcio Rogério Cunha,Cláudio L. Pereira da |
author_role |
author |
author2 |
Mehta,Niraj Magajevski,Adriano Oliveira,Larissa de Maluf,Débora Lee Smith Concato,Letícia Doubrawa,Eduardo Ortiz,Márcio Rogério Cunha,Cláudio L. Pereira da |
author2_role |
author author author author author author author author |
dc.contributor.author.fl_str_mv |
Távora-Mehta,Maria Zildany P. Mehta,Niraj Magajevski,Adriano Oliveira,Larissa de Maluf,Débora Lee Smith Concato,Letícia Doubrawa,Eduardo Ortiz,Márcio Rogério Cunha,Cláudio L. Pereira da |
dc.subject.por.fl_str_mv |
Orthostatic Intolerance/physiopathology Stroke Volume Vascular Resistance Postural Orthostatic Tachycardia Syndrome/physiopathology |
topic |
Orthostatic Intolerance/physiopathology Stroke Volume Vascular Resistance Postural Orthostatic Tachycardia Syndrome/physiopathology |
description |
Abstract Background: Orthostatic intolerance patients' pathophysiological mechanism is still obscure, contributing to the difficulty in their clinical management. Objective: To investigate hemodynamic changes during tilt test in individuals with orthostatic intolerance symptoms, including syncope or near syncope. Methods: Sixty-one patients who underwent tilt test at - 70° in the phase without vasodilators were divided into two groups. For data analysis, only the first 20 minutes of tilting were considered. Group I was made up of 33 patients who had an increase of total peripheral vascular resistance (TPVR) during orthostatic position; and Group II was made up of 28 patients with a decrease in TPVR (characterizing insufficient peripheral vascular resistance). The control group consisted of 24 healthy asymptomatic individuals. Hemodynamic parameters were obtained by a non-invasive hemodynamic monitor in three different moments (supine position, tilt 10' and tilt 20') adjusted for age. Results: In the supine position, systolic volume (SV) was significantly reduced in both Group II and I in comparison to the control group, respectively (66.4 ±14.9 ml vs. 81.8±14.8 ml vs. 101.5±24.2 ml; p<0.05). TPVR, however, was higher in Group II in comparison to Group I and controls, respectively (1750.5± 442 dyne.s/cm5 vs.1424±404 dyne.s/cm5 vs. 974.4±230 dyne.s/cm5; p<0.05). In the orthostatic position, at 10', there was repetition of findings, with lower absolute values of SV compared to controls (64.1±14.0 ml vs 65.5±11.3 ml vs 82.8±15.6 ml; p<0.05). TPVR, on the other hand, showed a relative drop in Group II, in comparison to Group I. Conclusion: Reduced SV was consistently observed in the groups of patients with orthostatic intolerance in comparison to the control group. Two different responses to tilt test were observed: one group with elevated TPVR and another with a relative drop in TPVR, possibly suggesting a more severe failure of compensation mechanisms. |
publishDate |
2016 |
dc.date.none.fl_str_mv |
2016-10-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0066-782X2016004300354 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0066-782X2016004300354 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
10.5935/abc.20160135 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Sociedade Brasileira de Cardiologia - SBC |
publisher.none.fl_str_mv |
Sociedade Brasileira de Cardiologia - SBC |
dc.source.none.fl_str_mv |
Arquivos Brasileiros de Cardiologia v.107 n.4 2016 reponame:Arquivos Brasileiros de Cardiologia (Online) instname:Sociedade Brasileira de Cardiologia (SBC) instacron:SBC |
instname_str |
Sociedade Brasileira de Cardiologia (SBC) |
instacron_str |
SBC |
institution |
SBC |
reponame_str |
Arquivos Brasileiros de Cardiologia (Online) |
collection |
Arquivos Brasileiros de Cardiologia (Online) |
repository.name.fl_str_mv |
Arquivos Brasileiros de Cardiologia (Online) - Sociedade Brasileira de Cardiologia (SBC) |
repository.mail.fl_str_mv |
||arquivos@cardiol.br |
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1752126566323716096 |