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血管迷走性晕厥中心血管抑制的变异性：心血管抑制期间和之后亚组之间的差异。

Variability of cardioinhibition in vasovagal syncope: differences between subgroups during cardioinhibition and beyond.

机构信息

Department of Neurology, Leiden University Medical Centre, PO Box 9600, 2300, Leiden, The Netherlands.

Heart Centre, Department of Clinical and Experimental Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands.

出版信息

Clin Auton Res. 2023 Dec;33(6):749-755. doi: 10.1007/s10286-023-00991-5. Epub 2023 Oct 24.

DOI:10.1007/s10286-023-00991-5
PMID:37874434
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10751252/
Abstract

PURPOSE

We compared hemodynamic parameters between subjects with marked, intermediate and minimal cardioinhibition during vasovagal syncope.

METHODS

The study included subjects with a decrease in heart rate while experiencing a complete vasovagal syncope during tilt-table testing. The subjects were classified as having marked, intermediate or minimal cardioinhibition, based on tertile values of the decrease in heart rate. Hemodynamic parameters between these groups were compared before tilt in the supine position, shortly after tilt and during cardioinhibition.

RESULTS

A total of 149 subjects with a median age of 43 (interquartile range 24-60) years were included in the study. Among the three groups with different levels of cardioinhibition, the highest heart rate was observed in subjects with marked cardioinhibition both before and shortly after tilt and at the start of cardioinhibition. The heart rate decrease in these subjects was both larger and faster compared to subjects with minimal and intermediate cardioinhibition.

CONCLUSION

Subjects with marked cardioinhibition have both a larger and faster decrease in heart rate compared to subjects with intermediate and minimal cardioinhibition, as early as from the start of cardioinhibition. Marked cardioinhibition is related to differences in hemodynamic profiles already present well before the start of cardioinhibition.

摘要

目的

我们比较了血管迷走性晕厥患者在心动过缓明显、中度和轻度时的血流动力学参数。

方法

本研究纳入了在倾斜试验期间出现心率完全下降时出现血管迷走性晕厥的患者。根据心率下降的三分位值，将患者分为心动过缓明显、中度和轻度。比较这些组在倾斜前仰卧位、倾斜后不久和心动过缓期间的血流动力学参数。

结果

共纳入 149 名年龄中位数为 43（四分位间距 24-60）岁的患者。在心动过缓程度不同的三组中，心动过缓明显组的最高心率无论是在倾斜前还是倾斜后不久以及心动过缓开始时都高于心动过缓中度和轻度组。与心动过缓中度和轻度组相比，这些患者的心率下降幅度更大、速度更快。

结论

与心动过缓中度和轻度组相比，心动过缓明显组从心动过缓开始时就表现出更大和更快的心率下降。心动过缓明显与心动过缓开始前就存在的血流动力学特征差异有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f3db/10751252/2e6a3af96ad2/10286_2023_991_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f3db/10751252/b9ae2186933f/10286_2023_991_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f3db/10751252/a09edea01bd8/10286_2023_991_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f3db/10751252/2e6a3af96ad2/10286_2023_991_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f3db/10751252/b9ae2186933f/10286_2023_991_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f3db/10751252/a09edea01bd8/10286_2023_991_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f3db/10751252/2e6a3af96ad2/10286_2023_991_Fig3_HTML.jpg

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The pathophysiology of vasovagal syncope: Novel insights.血管迷走性晕厥的病理生理学：新的见解。
Auton Neurosci. 2021 Dec;236:102899. doi: 10.1016/j.autneu.2021.102899. Epub 2021 Oct 18.
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