What is Pre-Syncope

Cardiac and Vascular Sympathetic Baroreflex Control during Orthostatic Pre-Syncope


Furlan, R. and Heusser, K. and Minonzio, M. and Shiffer, D. and Cairo, B. and Tank, J. and Jordan, J. and Diedrich, A. and Gauger, P. and Zamuner, Roberto, A . and Dipaola, F. and Porta, A. and Barbic, F. (2019) Cardiac and Vascular Sympathetic Baroreflex Control during Orthostatic Pre-Syncope. Journal of Clinical Medicine, 8 (9), page 1434. Multidisciplinary Digital Publishing Institute (MDPI). doi: 10.3390 / jcm8091434. ISSN 2077-0383.

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Official URL: https://www.mdpi.com/2077-0383/8/9/1434

short version

We hypothesized that sympathetic baroreflex mediated uncoupling between neural sympathetic discharge pattern and arterial pressure (AP) fluctuations at 0.1 Hz during baroreceptor unloading might promote orthostatic pre-syncope. Ten volunteers (32 ± 6 years) underwent electrocardiogram, beat-to-beat AP, respiratory activity and muscle sympathetic nerve activity (MSNA) recordings while supine (REST) ​​and during 80 ° head-up tilt (HUT) followed by −10 mmHg stepwise increase of lower body negative pressure until pre-syncope. Cardiac and sympathetic baroreflex sensitivity were quantified. Spectrum analysis of systolic and diastolic AP (SAP and DAP) and calibrated MSNA (cMSNA) variability assessed the low frequency fluctuations (LF, ~ 0.1 Hz) of SAP, DAP and cMSNA variability. The squared coherence function (K2) quantified the coupling between cMSNA and DAP in the LF band. Analyzes were performed while supine, during asymptomatic HUT (T1) and at pre-syncope onset (T2). During T2 we found that: (1) sympathetic baroreceptor modulation was virtually abolished compared to T1; (2) a progressive decrease in AP was accompanied by a persistent but chaotic sympathetic firing; (3) coupling between cMSNA and AP series at 0.1 Hz was reduced compared to T1. A negligible sympathetic baroreceptor modulation during pre-syncope might disrupt sympathetic discharge pattern impairing the capability of vessels to constrict and promote pre-syncope.

elib URL of the entry:https://elib.dlr.de/129779/
Document type:Journal contribution
Title:Cardiac and Vascular Sympathetic Baroreflex Control during Orthostatic Pre-Syncope
Authors:
AuthorsInstitution or email addressAuthor-ORCID-iD
Furlan, R.Department of Internal Medicine, Humanitas Clinical and Research Center, Rozzano (MI), Humanitas University, Rozzano, ItalyNOT SPECIFIED
Heusser, K.Institute of Aerospace Medicine, German Aerospace Center (DLR), Cologne, Germany.NOT SPECIFIED
Minonzio, M.Department of Internal Medicine, Humanitas Clinical and Research Center, Rozzano (MI), Humanitas University, Rozzano, ItalyNOT SPECIFIED
Shiffer, D.Department of Internal Medicine, Humanitas Clinical and Research Center, Rozzano (MI), Humanitas University, Rozzano, ItalyNOT SPECIFIED
Cairo, B.Department of Biomedical Sciences for Health, University of Milan, Milan, ItalyNOT SPECIFIED
Tank, J.Institute of Aerospace Medicine, German Aerospace Center (DLR), Cologne, Germany.NOT SPECIFIED
Jordan, J.Institute of Aerospace Medicine, German Aerospace Center (DLR), Cologne, Germany.NOT SPECIFIED
Diedrich, A.Division of Clinical Pharmacology, Department of Medicine, Autonomic Dysfunction Service, Vanderbilt University, Nashville, TNNOT SPECIFIED
Gauger, P.Institute of Aerospace Medicine, German Aerospace Center (DLR), Cologne, Germany.NOT SPECIFIED
Zamuner, Roberto, A.Department of Kinesiology, Universidad Católica del Maule, 3530000 Talca, Maule, ChileNOT SPECIFIED
Dipaola, F.Department of Internal Medicine, Humanitas Clinical and Research Center, IRCCS, Humanitas University,NOT SPECIFIED
Porta, A.Department of Biomedical Sciences for Health, University of Milan, Milan, Italy; Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, San Donato Milanese, Milan, ItalyNOT SPECIFIED
Barbic, F.Department of Internal Medicine, Humanitas Clinical and Research Center, Rozzano (MI), Humanitas University, Rozzano, ItalyNOT SPECIFIED
Date:10 September 2019
Published in:Journal of Clinical Medicine
Refereed publication:Yes
Open Access:Yes
Gold Open Access:Yes
In SCOPUS:Yes
In ISI Web of Science:Yes
Tape:8
DOI:10.3390 / jcm8091434
Side area:Page 1434
Publishing company:Multidisciplinary Digital Publishing Institute (MDPI)
ISSN:2077-0383
Status:released
Keywords:syncope; vasovagal; baroreceptors; muscle sympathetic nerve activity; power spectrum analysis; heart rate variability; blood pressure variability; MSNA variability
HGF - research area:Aviation, Space and Transportation
HGF program:Space travel
HGF - program topic:Research under space conditions
DLR - focus:Space travel
DLR - research area:R FR - research under space conditions
DLR - sub-area (project, plan):R - System Physiology Project (old)
Location: Cologne-Porz
Institutes & facilities:Institute for Aerospace Medicine
Institute of Aerospace Medicine> Cardiovascular Aerospace Medicine
Institute for Aerospace Medicine> Head of ME
Deposited by:Schrage, Larissa
Deposited on:29 Oct 2019 13:35
Last change:31 Oct 2020 04:35

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