Cerebral autoregulation is preserved in postural tachycardia syndrome
Cerebral autoregulation is preserved in postural tachycardia syndrome
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DOI：
10.1152/japplphysiol.00225.2005
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发表时间：
2005-09-01
影响因子：
3.3
通讯作者：
Stein, R
中科院分区：
文献类型：
--
作者：
Schondorf, R;Benoit, J;Stein, R
为了检测体位性心动过速综合征（POTS）患者的脑自动调节是否受损，我们评估了17名健康对照者和27名POTS患者。血压，心率和脑血流速度（经颅多普勒）记录在休息和80度头向上倾斜（HUT）。静态脑自动调节，评估从脑血管阻力的变化在HUT，是相同的POTS和对照组。动态脑自动调节的属性推断从传输增益，相干性，和相位的血压和脑血流速度之间的关系估计从过滤的数据段（0.02-0.8 Hz）。POTS患者的动态脑自动调节与对照组无差异。患者的动态脑自动调节在HUT过程中没有改变，尽管心动过速增加提示直立性应激恶化。军用抗休克裤的充气大大减少了POTS患者的心动过速，而不影响脑自动调节。在军用抗休克裤充气后，一半患者的立位不耐受症状减轻。我们的结论是，许多POTS患者的脑灌注和自动调节与正常对照组无差异。
To test whether cerebral autoregulation is impaired in patients with postural tachycardia syndrome (POTS), we evaluated 17 healthy control subjects and 27 patients with POTS. Blood pressure, heart rate, and cerebral blood velocity (transcranial Doppler) were recorded at rest and during 80 degrees head-up tilt (HUT). Static cerebral autoregulation, as assessed from the change in cerebrovascular resistance during HUT, was the same in POTS and in controls. The properties of dynamic cerebral autoregulation were inferred from transfer gain, coherence, and phase of the relationship between blood pressure and cerebral blood velocity estimated from filtered data segments (0.02-0.8 Hz). Dynamic cerebral autoregulation of patients with POTS did not differ from that of controls. The patients' dynamic cerebral autoregulation did not change over the course of HUT, despite increased tachycardia suggestive of worsening orthostatic stress. Inflation of military anti-shock trouser pants substantially reduced the tachycardia of patients with POTS without affecting cerebral autoregulation. Symptoms of orthostatic intolerance were reduced in one-half of the patients following military anti-shock trouser pants inflation. We conclude that cerebral perfusion and autoregulation in many patients with POTS do not differ from that of normal control subjects.