血管迷走性晕厥患者的基线心脏自主神经功能正常,瞳孔副交感神经张力增强

IF 1.3 4区 医学 Q4 PHYSIOLOGY
Udi Nussinovitch, Sapir Barak-Lanciano, Itay Shavit, Ishay Avivi, Ella Haber-Kaptsenel, Hagar Palacci, Chen Chaiat, Ronen Rubinshtein
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引用次数: 0

摘要

血管迷走性晕厥(VVS)患者在基线时是否会出现异常的自主神经反应,以及特定的诊断方法是否具有诊断价值,这些问题都存在争议。我们研究了瞳孔光反射和心脏自主神经测试是否可用于识别有血管迷走性晕厥病史的志愿者的自主神经功能障碍。研究小组包括 128 名健康志愿者,其中 31 人有典型的 VVS 病史。在严格的条件下,使用自动商用红外线瞳孔计对右侧瞳孔进行了评估。除了瞳孔缩小和瞳孔散大动力学外,还测量了瞳孔直径。使用高分辨率心电图和指定软件对静息时的心率变异性和站立时的心率变化进行了量化。两组患者的人口统计学和临床特征相似。经单变量分析(3.83 ± 0.59 vs. 3.56 ± 0.73 mm/s,p = 0.042)和校正潜在混杂因素(p = 0.049)后,VVS 患者的平均收缩速度(ACV)明显更高。所有其他瞳孔测量指数和心率指数在各组之间具有可比性。有 VVS 病史的患者对光刺激的反应表现为瞳孔副交感神经过度活跃,表现为 ACV 增加。这一发现对预后的影响以及使用这一简单的临床工具来识别晕厥后有可能频繁发生 VVS 或身体损伤的患者的意义值得进一步研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Normal baseline cardiac autonomic function and increased pupillary parasympathetic tone in patients with vasovagal syncope

Normal baseline cardiac autonomic function and increased pupillary parasympathetic tone in patients with vasovagal syncope

It is controversial whether people with vasovagal syncope (VVS) have abnormal autonomic responses at baseline and whether specific diagnostic manoeuvres have a diagnostic value. We investigated whether the pupillary light reflex and cardiac autonomic tests can be used to identify autonomic dysfunction in volunteers with a medical history of VVS. The study groups included 128 healthy volunteers, of whom 31 reported a history of typical VVS. The right pupil was evaluated using an automated, commercial infra-red pupillometer under strict conditions. In addition to miosis and mydriasis kinetics, pupil diameters were measured. Heart rate variability at rest and heart rate changes to standing were quantified with high-resolution electrocardiography and designated software. The demographic and clinical characteristics of both groups were statistically similar. Average constriction velocity (ACV) was significantly higher in VVS patients following a univariate analysis (3.83 ± 0.59 vs. 3.56 ± 0.73 mm/s, p = 0.042) and after correcting for potential confounders (p = 0.049). All other pupillometric and heart rate indices were comparable between groups. Patients with a history of VVS depict pupillary parasympathetic overactivity in response to light stimuli, manifested as increased ACV. The prognostic implications of this finding and the significance of using this simple clinical tool to identify patients who are at risk for developing frequent episodes of VVS or physical injuries following a syncope merits further study.

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来源期刊
CiteScore
3.40
自引率
5.60%
发文量
62
审稿时长
6-12 weeks
期刊介绍: Clinical Physiology and Functional Imaging publishes reports on clinical and experimental research pertinent to human physiology in health and disease. The scope of the Journal is very broad, covering all aspects of the regulatory system in the cardiovascular, renal and pulmonary systems with special emphasis on methodological aspects. The focus for the journal is, however, work that has potential clinical relevance. The Journal also features review articles on recent front-line research within these fields of interest. Covered by the major abstracting services including Current Contents and Science Citation Index, Clinical Physiology and Functional Imaging plays an important role in providing effective and productive communication among clinical physiologists world-wide.
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