Publication
Tilt Training Increases Vasoconstrictor Reserve in Patients with Neurocardiogenic Syncope
| dc.contributor.author | Laranjo, S | |
| dc.contributor.author | Oliveira, MM | |
| dc.contributor.author | Tavares, C | |
| dc.contributor.author | Geraldes, V | |
| dc.contributor.author | Santos, S | |
| dc.contributor.author | Oliveira, E | |
| dc.contributor.author | Cruz Ferreira, R | |
| dc.contributor.author | Rocha, I | |
| dc.date.accessioned | 2014-11-05T13:26:38Z | |
| dc.date.available | 2014-11-05T13:26:38Z | |
| dc.date.issued | 2012 | |
| dc.description.abstract | Neurocardiogenic syncope (NCS) is a common clinical entity resulting from an excessive reflex autonomic response, particularly during orthostatism. Treatment options are controversial and of limited effectiveness. Tilt training (TT) is a promising option to treat these patients. However, its mechanism of action and clinical impact remain unclear. OBJECTIVE: To characterize hemodynamic and autonomic responses during a TT program in patients with NCS refractory to conventional measures. METHODS: We studied 28 patients (50% male, mean age 41±14 years) without structural heart disease, with NCS documented by tilt testing. The TT program included 9 tilt sessions (3 times a week, 30 min) (60° - 6 sessions, 70° - 3 sessions), under ECG and blood pressure monitoring combined with home orthostatic self-training and 10° head-up during sleep. Systolic volume, cardiac output, total peripheral resistance, baroreflex sensitivity and heart-rate variability were computed. Patients were reassessed at 1 month and every 6 months for a maximum of 36 months (24±12 months). RESULTS: Over the course of the TT program there was a significant increase in total peripheral resistance (1485±225 vs. 1591±187 dyn·s·cm(-5), p<0.05), with a decrease in standard deviation (206±60 vs. 150±42, p<0.05). During follow-up, syncope recurred in five patients (19%), with a significant reduction in the number of episodes (4.0±3.2/patient in the 12 months before TT vs. 1.4±0.8/patient post-TT, p<0.05). CONCLUSION: In refractory NCS, TT may be an effective therapeutic option, with long-term benefits. These results appear to be due to an increase in vasoconstrictor reserve combined with a reduction in its variance. | por |
| dc.identifier.citation | Rev Port Cardiol. 2012 Jul-Aug;31(7-8):469-76 | por |
| dc.identifier.uri | http://hdl.handle.net/10400.17/1940 | |
| dc.language.iso | eng | por |
| dc.peerreviewed | yes | por |
| dc.publisher | Sociedade Portuguesa de Cardiologia | por |
| dc.subject | HSM CAR | por |
| dc.subject | Síncope Vasovagal | por |
| dc.subject | Teste de Inclinação | por |
| dc.subject | Vasoconstrição | por |
| dc.title | Tilt Training Increases Vasoconstrictor Reserve in Patients with Neurocardiogenic Syncope | por |
| dc.title.alternative | O Treino de Ortostatismo (Tilt Training) Aumenta a Reserva Vasoconstritora em Doentes com Síncope Reflexa Neurocardiogénica | por |
| dc.type | journal article | |
| dspace.entity.type | Publication | |
| oaire.citation.endPage | 476 | por |
| oaire.citation.startPage | 469 | por |
| oaire.citation.title | Revista Portuguesa de Cardiologia | por |
| rcaap.rights | openAccess | por |
| rcaap.type | article | por |