Open AccessDiagnosis and prevention of the vasodepressor type of neurally mediated syncope in Japanese patients
Author(s) -
Misaki Hasegawa,
Tomoyoshi Komiyama,
Kengo Ayabe,
Susumu Satoh,
Taiji Sakai,
Kyong Hee Lee,
Masahiro Morise,
Atsuhiko Yagishita,
Mari Amino,
Ayumi Sasaki,
Eiichiro Nagata,
Hiroyuki Kobayashi,
Koichiro Yoshioka,
Yuji Ikari
Publication year - 2021
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0251450
Subject(s) - medicine , blood pressure , cardiology , heart rate , electrocardiography , adenylate kinase , fainting , anesthesia , tachycardia , receptor
We investigated circulatory dynamics in patients with vasodepressor type neurally mediated syncope (VT-NMS) by performing high-resolution Holter electrocardiography and a correlation analysis of changes in adenylate cyclase activity, blood pressure, and pulse during the head-up tilt test. Holter electrocardiography was performed for 30 patients. Adenylate cyclase activity was evaluated in lymphocytes from blood samples taken at rest and during the head-up tilt test. There was no change in autonomic nerve fluctuation during electrocardiography in VT-NMS patients, but our results showed a significant difference in blood pressure and adenylate cyclase activity between VT-NMS patients and healthy volunteers; the systolic blood pressure of VT-NMS patients decreased after 5 min, while at 10 min, the adenylate cyclase activity was the highest (0.53%) and the systolic blood pressure was the lowest (111.8 mm Hg). Pulse rates increased after 10 min. VT-NMS patients showed higher blood pressure, pulse rate, and adenylate cyclase activity during the tilt test than did healthy volunteers. In patients with syncope, standing for longer than 10 minutes may increase the risk of VT-NMS. From our results, we consider it likely that high systolic blood pressure and adenylate cyclase activity at rest cause fainting in VT-NMS patients. Our findings may be helpful for identifying individuals with a high risk of developing NMS in the healthy population.