Vasomotor reactivity as a predictor for syncope in patients with orthostatism

A. Y. Gur, E. Auriel, A. D. Korczyn, A. Gadoth, L. Shopin, N. Giladi, N. M. Bornstein, T. Gurevich

Research output: Contribution to journalArticlepeer-review

6 Scopus citations

Abstract

Objectives - Syncope in patients with orthostatic hypotension (OH) may be the result of impaired cerebral autoregulation. Cerebral autoregulation status can be determined by assessing cerebral vasomotor reactivity (VMR). We assessed and compared VMR in patients with OH with and without syncope. Material and methods - Twenty-nine patients with OH underwent transcranial Doppler (TCD) and the Diamox test (1g acetazolamide IV) for assessing VMR during elaboration of their OH syndrome. The percent difference between cerebral blood flow velocities (BFV) in the middle cerebral (MCA) and vertebral (VA) arteries before and after acetazolamide was defined as VMR%. We considered increases of BFV of ≥40% as being indicative of good VMR and classified our study patients as having good or impaired VMRs accordingly. Results - Mean VMR% values of the MCA and VA in patients with OH with syncope (n=12) were significantly lower as compared with patients with OH without syncope (n=17): 25.2±20.5% and 42.5±18.6%; 20.9±15.5% and 40.8±28.5%, respectively (P<0.05). Conclusions - Among patients with OH, we found an association between the presence of syncope and impaired VMR. Assessment of VMR among patients with OH may predict those who are at higher risk to faint and fall and to support more aggressive intervention.

Original languageEnglish
Pages (from-to)32-36
Number of pages5
JournalActa Neurologica Scandinavica
Volume126
Issue number1
DOIs
StatePublished - 1 Jul 2012
Externally publishedYes

Keywords

  • Acetazolamide
  • Cerebral autoregulation
  • Cerebrovascular reactivity
  • Doppler ultrasonography
  • Orthostatic hypotension
  • Syncope
  • Transcranial

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

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