Transcranial Doppler monitoring during head upright tilt table testing in patients with suspected neurocardiogenic syncope
The aim of the present study was to evaluate the mechanism of cerebrovascular autoregulation in patients with neurocardiogenic syncope using bilateral transcranial Doppler (TCD) monitoring during head upright tilt table testing (HUT). Two hundred and six patients were prospectively studied. One hund...
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2004
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| Acceso en línea: | https://bibliotecadigital.exactas.uba.ar/collection/paper/document/paper_10995129_v6_n1_p63_Albina http://hdl.handle.net/20.500.12110/paper_10995129_v6_n1_p63_Albina |
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paper:paper_10995129_v6_n1_p63_Albina2023-06-08T16:08:02Z Transcranial Doppler monitoring during head upright tilt table testing in patients with suspected neurocardiogenic syncope Head upright tilt table test Syncope Transcranial Doppler isosorbide dinitrate adolescent adult aged anamnesis article blood flow velocity bradycardia brain blood flow cardiovascular autoregulation child controlled study diastole Doppler echography drug response female head tilting human hypotension major clinical study male medical assessment patient monitoring priority journal syncope tilt table test brain circulation Doppler echography echography middle aged pathophysiology physiology tilt table test Adolescent Adult Aged Aged, 80 and over Blood Flow Velocity Cerebrovascular Circulation Child Female Humans Male Middle Aged Syncope, Vasovagal Tilt-Table Test Ultrasonography, Doppler, Transcranial The aim of the present study was to evaluate the mechanism of cerebrovascular autoregulation in patients with neurocardiogenic syncope using bilateral transcranial Doppler (TCD) monitoring during head upright tilt table testing (HUT). Two hundred and six patients were prospectively studied. One hundred and fifty-nine subjects (77%) had a prior history of syncope and 47 (23%) had presyncope. Ninety-nine patients (48%) had syncope or presyncope during HUT with a 76% fall in diastolic middle cerebral artery blood flow velocity (D-MCA-BFV). Systolic MCA-BFV (S-MCA-BFV) fell by 33%. Deepening of the dicrotic notch in the Doppler waveform always preceded the fall in D-MCA-BFV. Patients without syncope or presyncope (n=96) had smaller changes in cerebral blood flow velocities during HUT and only twenty-two subjects had transient deepening of the dicrotic notch. Eleven subjects had presyncope during HUT due to an exaggerated response to nitrates with progressive arterial hypotension without bradycardia and changes during TCD monitoring that were intermediate between positive and negative HUT. In conclusion, patients with neurocardiogenic syncope have changes in cerebral blood flow during the event. TCD monitoring during HUT helps to assess these alterations. © 2003. Published by Elsevier Ltd on behalf of The European Society of Cardiology. 2004 https://bibliotecadigital.exactas.uba.ar/collection/paper/document/paper_10995129_v6_n1_p63_Albina http://hdl.handle.net/20.500.12110/paper_10995129_v6_n1_p63_Albina |
| institution |
Universidad de Buenos Aires |
| institution_str |
I-28 |
| repository_str |
R-134 |
| collection |
Biblioteca Digital - Facultad de Ciencias Exactas y Naturales (UBA) |
| topic |
Head upright tilt table test Syncope Transcranial Doppler isosorbide dinitrate adolescent adult aged anamnesis article blood flow velocity bradycardia brain blood flow cardiovascular autoregulation child controlled study diastole Doppler echography drug response female head tilting human hypotension major clinical study male medical assessment patient monitoring priority journal syncope tilt table test brain circulation Doppler echography echography middle aged pathophysiology physiology tilt table test Adolescent Adult Aged Aged, 80 and over Blood Flow Velocity Cerebrovascular Circulation Child Female Humans Male Middle Aged Syncope, Vasovagal Tilt-Table Test Ultrasonography, Doppler, Transcranial |
| spellingShingle |
Head upright tilt table test Syncope Transcranial Doppler isosorbide dinitrate adolescent adult aged anamnesis article blood flow velocity bradycardia brain blood flow cardiovascular autoregulation child controlled study diastole Doppler echography drug response female head tilting human hypotension major clinical study male medical assessment patient monitoring priority journal syncope tilt table test brain circulation Doppler echography echography middle aged pathophysiology physiology tilt table test Adolescent Adult Aged Aged, 80 and over Blood Flow Velocity Cerebrovascular Circulation Child Female Humans Male Middle Aged Syncope, Vasovagal Tilt-Table Test Ultrasonography, Doppler, Transcranial Transcranial Doppler monitoring during head upright tilt table testing in patients with suspected neurocardiogenic syncope |
| topic_facet |
Head upright tilt table test Syncope Transcranial Doppler isosorbide dinitrate adolescent adult aged anamnesis article blood flow velocity bradycardia brain blood flow cardiovascular autoregulation child controlled study diastole Doppler echography drug response female head tilting human hypotension major clinical study male medical assessment patient monitoring priority journal syncope tilt table test brain circulation Doppler echography echography middle aged pathophysiology physiology tilt table test Adolescent Adult Aged Aged, 80 and over Blood Flow Velocity Cerebrovascular Circulation Child Female Humans Male Middle Aged Syncope, Vasovagal Tilt-Table Test Ultrasonography, Doppler, Transcranial |
| description |
The aim of the present study was to evaluate the mechanism of cerebrovascular autoregulation in patients with neurocardiogenic syncope using bilateral transcranial Doppler (TCD) monitoring during head upright tilt table testing (HUT). Two hundred and six patients were prospectively studied. One hundred and fifty-nine subjects (77%) had a prior history of syncope and 47 (23%) had presyncope. Ninety-nine patients (48%) had syncope or presyncope during HUT with a 76% fall in diastolic middle cerebral artery blood flow velocity (D-MCA-BFV). Systolic MCA-BFV (S-MCA-BFV) fell by 33%. Deepening of the dicrotic notch in the Doppler waveform always preceded the fall in D-MCA-BFV. Patients without syncope or presyncope (n=96) had smaller changes in cerebral blood flow velocities during HUT and only twenty-two subjects had transient deepening of the dicrotic notch. Eleven subjects had presyncope during HUT due to an exaggerated response to nitrates with progressive arterial hypotension without bradycardia and changes during TCD monitoring that were intermediate between positive and negative HUT. In conclusion, patients with neurocardiogenic syncope have changes in cerebral blood flow during the event. TCD monitoring during HUT helps to assess these alterations. © 2003. Published by Elsevier Ltd on behalf of The European Society of Cardiology. |
| title |
Transcranial Doppler monitoring during head upright tilt table testing in patients with suspected neurocardiogenic syncope |
| title_short |
Transcranial Doppler monitoring during head upright tilt table testing in patients with suspected neurocardiogenic syncope |
| title_full |
Transcranial Doppler monitoring during head upright tilt table testing in patients with suspected neurocardiogenic syncope |
| title_fullStr |
Transcranial Doppler monitoring during head upright tilt table testing in patients with suspected neurocardiogenic syncope |
| title_full_unstemmed |
Transcranial Doppler monitoring during head upright tilt table testing in patients with suspected neurocardiogenic syncope |
| title_sort |
transcranial doppler monitoring during head upright tilt table testing in patients with suspected neurocardiogenic syncope |
| publishDate |
2004 |
| url |
https://bibliotecadigital.exactas.uba.ar/collection/paper/document/paper_10995129_v6_n1_p63_Albina http://hdl.handle.net/20.500.12110/paper_10995129_v6_n1_p63_Albina |
| _version_ |
1768542377151037440 |