Impaired hemodynamic response to tilt, handgrip and Valsalva manoeuvre in patients with takotsubo syndrome
| Autor: | K Krzemiński, Grzegorz Opolski, Anna Gąsiorowska, Monika Budnik, Wiktor Niewiadomski, Robert Kowalik, Janusz Kochanowski, Anna Stępniewska, Katarzyna Żukowska, Katarzyna Mieczkowska, Katarzyna Szepietowska |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Adult
Sympathetic nervous system medicine.medical_specialty Sympathetic Nervous System Valsalva Maneuver Haemodynamic response Ischemia Hemodynamics Blood Pressure 03 medical and health sciences Cellular and Molecular Neuroscience 0302 clinical medicine Heart Rate Takotsubo Cardiomyopathy Tilt-Table Test Internal medicine medicine Humans cardiovascular diseases Aged Aged 80 and over Takotsubo syndrome Hand Strength Endocrine and Autonomic Systems business.industry Stroke volume Middle Aged medicine.disease Autonomic nervous system medicine.anatomical_structure Blood pressure Echocardiography Case-Control Studies Cardiology ST Elevation Myocardial Infarction Female Neurology (clinical) business 030217 neurology & neurosurgery |
| Zdroj: | Autonomic Neuroscience. 220:102555 |
| ISSN: | 1566-0702 |
| Popis: | Purpose Long-term β-adrenolytics treatment in takotsubo syndrome (TTS) patients is based on the premise, that TTS is strongly associated with sympathetic nervous system overactivity. The aim of the study was to establish hemodynamic response to tilt, handgrip and Valsalva manoeuvre in patients with takotsubo syndrome compared to healthy subjects (CONTROL) and patients after ST Elevation Myocardial Infarction (STEMI). Material and method Echocardiographic examination was performed at rest, ECG and continuously non-invasively measured arterial blood pressure were used for evaluation of hemodynamic responses to Valsalva manoeuvre, static handgrip (HG) followed by post-exercise ischemia, and tilt. Ten healthy women, 20 with TTS and 20 after STEMI, mean age 64 ± 8.5 years, participated in the study. Results Pressor response to Valsalva manoeuvre and tilt in TTS group was diminished in comparison to CONTROL and close to that of STEMI. During HG, increase of SBP was the lowest in TTS group. Data indirectly suggest that it was due to deficient stroke volume in TTS and STEMI patients during these manoeuvres; though echocardiographic findings at rest did not reveal any significant differences between groups. Conclusions Our data show that despite apparent resolution of the immediate effects of TTS, impaired response to cardiovascular challenge, similar to that in STEMI patients, persisted. As the manoeuvres applied mimic daily life situations, causes of impairment should be searched for and potential health risk evaluated. |
| Databáze: | OpenAIRE |
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