Clinical Autonomic Research

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ISSN / EISSN : 0959-9851 / 1619-1560
Published by: Springer Nature (10.1007)
Total articles ≅ 2,078
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, Elisabeth P. Golden, Meredith Bryarly, Tamara McGregor, Benjamin N. Nguyen, Margaret A. Moutvic, Jeremy K. Cutsforth-Gregory, Patricia M. Stevens, Claudia Z. Chou, Laura Rhee, et al.
Clinical Autonomic Research pp 1-4; https://doi.org/10.1007/s10286-022-00866-1

, Erika Parente, Anna Rago, Angelo Comune, Nunzia Laezza, Andrea Antonio Papa, Celeste Chamberland, Thao Huynh, Paolo Golino, Michele Brignole, et al.
Clinical Autonomic Research pp 1-7; https://doi.org/10.1007/s10286-022-00864-3

Abstract:
Aims: The aim of our study was to evaluate the prevalence and clinical predictors of cardioinhibitory (CI) responses with asystole at the nitroglycerin (NTG)-potentiated head-up tilt test (HUTT) in patients with a history of syncope admitted to a tertiary referral syncope unit. Methods: We retrospectively evaluated all consecutive patients who underwent NTG-potentiated HUTT for suspected reflex syncope at our institution from March 1 2017 to May 1 2020. The prevalence of HUTT-induced CI syncope was assessed. Univariate and multivariate analyses were performed to test the association of asystolic response to HUTT with a set of clinical covariates. Results: We enrolled 1285 patients (45 ± 19.1 years; 49.6% male); 368 (28.6%) showed HUTT-induced CI response with asystole. A multivariate analysis revealed that the following factors were independently associated with HUTT-induced CI syncope: male sex (OR 1.48; ConInt 1.14–1.92; P = 0.003), smoking (OR 2.22; ConInt 1.56–3.115; P < 0.001), traumatic syncope (OR: 2.81; ConInt 1.79–4.42; P < 0.001), situational syncope (OR 0.45; ConInt 0.27–0.73; P = 0.002), and the use of diuretics (OR 9.94; ConInt 3.83–25.76; P < 0.001). Conclusions: The cardioinhibitory syncope with asystole induced by NTG-potentiated HUTT is more frequent than previously reported. The male gender, smoking habit, history of traumatic syncope, and use of diuretics were independent predictors of HUTT-induced CI responses. Conversely, the history of situational syncope seems to reduce this probability.
, Brooke C. D. Hockin, Omnia M. Taha, Natalie D. Heeney, Erin L. Williams, Vera-Ellen M. Lucci, Rebekah H. Y. Lee, Michael J. Stacey, Nick Gall, Phil Chowienczyk, et al.
Published: 23 April 2022
Clinical Autonomic Research, Volume 32, pp 131-141; https://doi.org/10.1007/s10286-022-00860-7

Abstract:
Purpose: Bolus water drinking, at room temperature, has been shown to improve orthostatic tolerance (OT), probably via sympathetic activation; however, it is not clear whether the temperature of the water bolus modifies the effect on OT or the cardiovascular responses to orthostatic stress. The aim of this study was to assess whether differing water temperature of the water bolus would alter time to presyncope and/or cardiovascular parameters during incremental orthostatic stress. Methods: Fourteen participants underwent three head-up tilt (HUT) tests with graded lower body negative pressure (LBNP) continued until presyncope. Fifteen minutes prior to each HUT, participants drank a 500 mL bolus of water which was randomised, in single-blind crossover fashion, to either room temperature water (20 °C) (ROOM), ice-cold water (0–3 °C) (COLD) or warm water (45 °C) (WARM). Cardiovascular parameters were monitored continuously. Results: There was no significant difference in OT in the COLD (33 ± 3 min; p = 0.3321) and WARM (32 ± 3 min; p = 0.6764) conditions in comparison to the ROOM condition (31 ± 3 min). During the HUT tests, heart rate and cardiac output were significantly reduced (p < 0.0073), with significantly increased systolic blood pressure, stroke volume, cerebral blood flow velocity and total peripheral resistance (p < 0.0054), in the COLD compared to ROOM conditions. Conclusions: In healthy controls, bolus cold water drinking results in favourable orthostatic cardiovascular responses during HUT/LBNP without significantly altering OT. Using a cold water bolus may result in additional benefits in patients with orthostatic intolerance above those conferred by bolus water at room temperature (by ameliorating orthostatic tachycardia and enhancing vascular resistance responses). Further research in patients with orthostatic intolerance is warranted.
Andrew W. D’Souza, Jeung-Ki Yoo, Ryosuke Takeda, Mark B. Badrov, Elizabeth H. Anderson, Jessica I. Wiblin, Carol S. North, Alina Suris, Michael D. Nelson, J. Kevin Shoemaker, et al.
Published: 28 February 2022
Clinical Autonomic Research, Volume 32, pp 115-129; https://doi.org/10.1007/s10286-022-00858-1

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