Nitroglycerin induced syncope occurs in subjects with delayed phase shift of baroreflex action.

Nitroglycerin (NTG) administration occasionally leads to syncope due to severe hypotension and bradycardia. This reaction resembles neurocardiogenic syncope but it may occur when the patient is in the supine position. To address the possible role of prevailing autonomic tone and baroreflex control i...

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Publicado en:Pacing & Clinical Electrophysiology Vol. 25; no. 5; pp. 828 - 833
Autores principales: Melenovsky V, Wichterle D, Malik J, Simek J, Hradec J, Ceska R, Malik M
Formato: Journal Article
Publicado: Wiley-Blackwell May2002
Acceso en línea:Ver este registro en EBSCOhost
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      dt: May2002
      vid: 25
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        atl: Nitroglycerin induced syncope occurs in subjects with delayed phase shift of baroreflex action.
      aug:
        au:
          Melenovsky V
          Wichterle D
          Malik J
          Simek J
          Hradec J
          Ceska R
          Malik M
      sug:
        subj:
          Nitroglycerin Adverse Effects
          Pressoreceptors Drug Effects
          Supine Position Physiology
          Syncope Chemically Induced
          Adult
          Blood Pressure Determination
          Blood Pressure Drug Effects
          Bradycardia Chemically Induced
          Electrocardiography
          Heart Rate Drug Effects
          Hypotension Chemically Induced
          Male
          Middle Age
          Nitroglycerin Administration and Dosage
          Nitroglycerin Pharmacodynamics
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Male
      ab: Nitroglycerin (NTG) administration occasionally leads to syncope due to severe hypotension and bradycardia. This reaction resembles neurocardiogenic syncope but it may occur when the patient is in the supine position. To address the possible role of prevailing autonomic tone and baroreflex control in precipitation of NTG induced syncope, continuous noninvasive blood pressure and an EGG were taken shortly before NTG application in the supine position. Frequency-domain measures of heart rate variability (HBV) and noninvasive indices of baroreflex were compared between subjects who did (n = 6) and did not (n = 41) develop syncope after NTG. Both groups differed only in the phase shift (PCR) between oscillations of blood pressure and heart rate during controlled respiration (0.1 Hz). PCR was significantly delayed in subjects who developed syncope than in controls (- 99.3 ± 14.1 vs -65,5 ± 27,0 degrees, P = 0.002). Thus, subjects with prolonged PCR are prone to NTG induced syncope because of increased lagging and, consequently, less stable baroreflex control.
      pubtype: Academic Journal
      doctype: Journal Article
      ougenre: Article
    language: English
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