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Cerebral Oxygenation Responses to Standing in Young Patients with Vasovagal Syncope.

Published version

Published version
Peer-reviewed

Repository DOI


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Authors

Pérez-Denia, Laura  ORCID logo  https://orcid.org/0000-0002-7442-1612
Claffey, Paul 
O'Reilly, Ailbhe 
Delgado-Ortet, Maria  ORCID logo  https://orcid.org/0000-0001-6511-6221
Rice, Ciara 

Abstract

Vasovagal syncope (VVS) is common in young adults and is attributed to cerebral hypoperfusion. However, during active stand (AS) testing, only peripheral and not cerebral hemodynamic responses are measured. We sought to determine whether cerebral oxygenation responses to an AS test were altered in young VVS patients when compared to the young healthy controls. A sample of young healthy adults and consecutive VVS patients attending a Falls and Syncope unit was recruited. Continuous beat-to-beat blood pressure (BP), heart rate, near-infrared spectroscopy (NIRS)-derived tissue saturation index (TSI), and changes in concentration of oxygenated/deoxygenated Δ[O2Hb]/Δ[HHb] hemoglobin were measured. BP and NIRS-derived features included nadir, peak, overshoot, trough, recovery rate, normalized recovery rate, and steady-state. Multivariate linear regression was used to adjust for confounders and BP. In total, 13 controls and 27 VVS patients were recruited. While no significant differences were observed in the TSI and Δ[O2Hb], there was a significantly smaller Δ[HHb] peak-to-trough and faster Δ[HHb] recovery rate in VVS patients, independent of BP. A higher BP steady-state was observed in patients but did not remain significant after multiple comparison correction. Young VVS patients demonstrated a similar cerebral circulatory response with signs of altered peripheral circulation with respect to the controls, potentially due to a hyper-reactive autonomic nervous system. This study sets the grounds for future investigations to understand the role of cerebral regulation during standing in VVS.

Description

Peer reviewed: True


Funder: Fundació Universitària Agustí Pedro i Pons, Universitat de Barcelona

Keywords

cerebral oxygenation, near-infrared spectroscopy, orthostatic, standing, syncope, young

Journal Title

J Clin Med

Conference Name

Journal ISSN

2077-0383
2077-0383

Volume Title

12

Publisher

MDPI AG
Sponsorship
Irish Research Council (GOIPG/2018/134)
Science Foundation Ireland and Irish Research Council (19/IFA/7409, GOIPG/2018/134)