Abnormal cardiovascular response to nitroglycerin in migraine
| Autor: | Dirk P Saal, Willebrordus Pj van Oosterhout, Michel D. Ferrari, J. Gert van Dijk, Roland D. Thijs, Guus G. Schoonman |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
medicine.medical_specialty total peripheral resistance Migraine Disorders Vasodilator Agents Blood Pressure Vasodilation 030204 cardiovascular system & hematology Systemic circulation Autonomic control Nitroglycerin 03 medical and health sciences 0302 clinical medicine Heart Rate autonomous nervous system Internal medicine medicine Humans Prospective Studies circulatory physiology Vasovagal syncope Migraine business.industry Original Articles General Medicine Middle Aged medicine.disease vasodilatation Pathophysiology 3. Good health Case-Control Studies Cardiology Administration Intravenous Female Neurology (clinical) Autonomous nervous system business 030217 neurology & neurosurgery medicine.drug |
| Zdroj: | Cephalalgia |
| ISSN: | 1468-2982 0333-1024 |
| Popis: | Introduction Migraine and vasovagal syncope are comorbid conditions that may share part of their pathophysiology through autonomic control of the systemic circulation. Nitroglycerin can trigger both syncope and migraine attacks, suggesting enhanced systemic sensitivity in migraine. We aimed to determine the cardiovascular responses to nitroglycerin in migraine. Methods In 16 women with migraine without aura and 10 age- and gender-matched controls without headache, intravenous nitroglycerin (0.5 µg·kg−1·min−1) was administered. Finger photoplethysmography continuously assessed cardiovascular parameters (mean arterial pressure, heart rate, cardiac output, stroke volume and total peripheral resistance) before, during and after nitroglycerin infusion. Results Nitroglycerin provoked a migraine-like attack in 13/16 (81.2%) migraineurs but not in controls ( p = .0001). No syncope was provoked. Migraineurs who later developed a migraine-like attack showed different responses in all parameters vs. controls (all p Discussion Migraineurs who developed a migraine-like attack in response to nitroglycerin showed stronger systemic cardiovascular responses compared to non-headache controls. The stronger systemic cardiovascular responses in migraine suggest increased systemic sensitivity to vasodilators, possibly due to insufficient autonomic compensatory mechanisms. |
| Databáze: | OpenAIRE |
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