Utilize este identificador para referenciar este registo: http://hdl.handle.net/10400.17/1940
Título: Tilt Training Increases Vasoconstrictor Reserve in Patients with Neurocardiogenic Syncope
Outros títulos: O Treino de Ortostatismo (Tilt Training) Aumenta a Reserva Vasoconstritora em Doentes com Síncope Reflexa Neurocardiogénica
Autor: Laranjo, S
Oliveira, MM
Tavares, C
Geraldes, V
Santos, S
Oliveira, E
Cruz Ferreira, R
Rocha, I
Palavras-chave: HSM CAR
Síncope Vasovagal
Teste de Inclinação
Vasoconstrição
Data: 2012
Editora: Sociedade Portuguesa de Cardiologia
Citação: Rev Port Cardiol. 2012 Jul-Aug;31(7-8):469-76
Resumo: 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.
Peer review: yes
URI: http://hdl.handle.net/10400.17/1940
Aparece nas colecções:CAR - Artigos

Ficheiros deste registo:
Ficheiro Descrição TamanhoFormato 
RPC 2012 469.pdf235,56 kBAdobe PDFVer/Abrir


FacebookTwitterDeliciousLinkedInDiggGoogle BookmarksMySpace
Formato BibTex MendeleyEndnote Degois 

Todos os registos no repositório estão protegidos por leis de copyright, com todos os direitos reservados.