Krediet C T Paul, Wieling Wouter
Department of Internal Medicine, Academic Medical Center at the University of Amsterdam, Meibergdreef 9, F4-222, 1105 AZ, Amsterdam, The Netherlands.
Europace. 2008 Apr;10(4):486-8. doi: 10.1093/europace/eun022. Epub 2008 Feb 29.
Cough syncope typically occurs in middle aged and senior, muscularly built males with a history of chronic obstructive lung disease. Originally, cough syncope was thought to be a form of epilepsy and only in the 1940s it was recognized to be of syncopal nature. The circulatory pathophysiology is, however, still not fully understood. We present data on two cough syncope patients in whom we documented the beat-to-beat changes in cardiac output and total peripheral resistance during cough syncope using pulse wave analysis. Our results give support to Edward P. Sharpey-Schafer's hypothesis that a decrease of total peripheral resistance plays a pivotal role in the pathophysiology of cough syncope. Systematic studies are needed to confirm this mechanism in larger series of patients.
咳嗽性晕厥通常发生在患有慢性阻塞性肺疾病的中老年、体格健壮的男性身上。最初，咳嗽性晕厥被认为是癫痫的一种形式，直到20世纪40年代才被确认为具有晕厥性质。然而，其循环病理生理学仍未被完全理解。我们展示了两名咳嗽性晕厥患者的数据，在这些患者中，我们使用脉搏波分析记录了咳嗽性晕厥期间心输出量和总外周阻力的逐搏变化。我们的结果支持了爱德华·P·沙佩伊-谢弗的假设，即总外周阻力的降低在咳嗽性晕厥的病理生理学中起关键作用。需要进行系统研究以在更多患者系列中证实这一机制。
