Universita degli Studi di Perugia, Istituto di Clinica Oculistica, Seconda Cattedra, Perugia, Italy
Department of Clinical Medicine, Cardiovascular and Immunological Sciences, Federico II University School of Medicine, Naples, Italy
Department of Morphological and Functional Sciences, Division of Nuclear Medicine, Federico II University School of Medicine, Naples, Italy
References: Abboud, F.M., Ventricular syncope: Is the heart a sensory organ? (1989) N Engl J Med, 320, pp. 390-39
Maron, B.J., Epstein, S.E., Hypertrophic cardiomyopathy: A discussion of nomenclature (1979) Am J Cardiol, 43, pp. 1242-1244
Betocchi, S., Piscione, F., Villari, B., Pace, L., Ciarmiello, A., Perrone-Filardi, P., Salvatore, C., Chiariello, M., Effects of induced asynchrony on left ventricular diastolic function in patients with coronary artery disease (1993) J Am Coll Cardiol, 21, pp. 1124-1131
Pace, L., Cuocolo, A., Nappi, A., Nicolai, E., Trimarco, B., Salvatore, M., Accuracy and reproducibility of left ventricular systolic and diastolic function measurements using an ambulatory radionuclide monitor (1992) Eur J Nucl Med, 19, pp. 800-806
Tamaki, N., Yasuda, T., Moore, R.H., Gill, G.B., Boucher, C.A., Hulter, A.M., Gold, H.K., Strauss, H.W., Continuous monitoring of left ventricular function by an ambulatory radionuclide detector in patients with coronary artery disease (1988) J Am Coll Cardiol, 2, pp. 669-679
Liu, J.E., Hahn, R.T., Stein, K.M., Markowitz, S.M., Okin, P.M., Devereux, R.B., Lerman, B.B., Left ventricular geometry and function preceding neurally mediated syncope (2000) Circulation, 101, pp. 777-783
Sahn, D.J., DeMaria, A., Kisslo, J., Weiman, A., Recommendations regarding quantitation in M-mode echocardiography: Results of a survey of echocardiographic measurements (1978) Circulation, 58, pp. 1072-1083
Spirito, P., Maron, B.J., Bonow, R.O., Epstein, S.E., Occurrence and significance of progressive left ventricular thinning and relative cavity dilatation in hypertrophic cardiomyopathy (1987) Am J Cardiol, 59, pp. 123-129
Briguori, C., Betocchi, S., Losi, M.A., Manganelli, F., Piscione, F., Pace, L., Boccalatte, M., Chiariello, M., Noninvasive evaluation of left ventricular diastolic function in hypertrophic cardiomyopathy (1998) Am J Cardiol, 81, pp. 180-187
Rossvolt, O., Hatle, L.K., Pulmonary venous flow velocities recorded by transthoracic Doppler ultrasound: Relation to left ventricular diastolic pressures (1993) J Am Coll Cardiol, 21, pp. 1687-1692
Cohen, G.I., Pietrolungo, J.F., Thomas, J.D., Klein, A.L., A practical guide to assessment of ventricular function using Doppler echocardiography (1996) J Am Coll Cardiol, 27, pp. 1753-1760
Manganelli, F., Betocchi, S., Losi, M.A., Briguori, C., Pace, L., Ciampi, Q., Perrone-Filardi, P., Chiariello, M., Influence of left ventricular cavity size on clinical presentation in hypertrophic cardiomyopathy (1999) Am J Cardiol, 83, pp. 547-552
Nienaber, C.A., Hiller, S., Spielmann, R.P., Geiger, M., Kuck, K.-H., Syncope in hypertrophic cardiomyopathy: Multivariate analysis of prognostic determinants (1995) J Am Coll Cardiol, 15, pp. 948-955
Gwathmey, J.K., Warren, S.E., Briggs, G.M., Copelas, L., Feldman, M.D., Phillips, P.J., Callahan M., Jr., Morgan, J.P., Diastolic dysfunction in hypertrophic cardiomyopathy. Effect on active force generation during systole (1991) J Clin Invest, 87, pp. 1023-1031
Hargreaves, A.D., Muir, A.L., Lack of variation in venous tone potentiates vasovagal syncope (1992) Br Heart J, 67, pp. 486-490
Sneddon, J.F., Counihan, P.J., Bashir, Y., Haywood, G.A., Ward, D.E., Camm, A.J., Impaired immediate vasoconstrictor responses in patient with recurrent neurally mediate vasovagal syncope (1993) Am J Cardiol, 71, pp. 72-76
Thomson, H.L., Wright, K., Frenneaux, M., Baroreflex sensitivity in patients with vasovagal syncope (1997) Circulation, 95, pp. 395-400
Almquist, A., Goldenberg, I.F., Milstein, S., Chen, M.-Y., Chen, X.-C., Hansen, R., Gornick, C.C., Benditt, D.G., Provocation of bradycardia and hypotension by isoproterenol and upright posture in patients with unexplained syncope (1989) N Engl J Med, 320, pp. 346-351
Kikushima, S., Kobayashi, Y., Nakagawa, H., Katagiri, T., Triggering mechanism for neurally mediated syncope induced by head-up tilt test (1999) J Am Coll Cardiol, 33, pp. 350-357
Leonelli, F.M., Wang, K., Evans, J.M., Patwardhan, A.R., Ziegler, M.G., Natale, A., Kim, C.S., Knapp, C.F., False positive head-up tilt test: Hemodynamic and neurohumoral profile (2000) J Am Coll Cardiol, 35, pp. 188-193
Frenneaux, M.P., Counihan, P.J., Caforio, A.L.P., Chikamori, T., McKenna, W.J., Abnormal blood pressure response during exercise in hypertrophic cardiomyopathy (1990) Circulation, 82, pp. 1995-2002
Gilligan, D.M., Chan, W.L., Ang, E.L., Oakley, C.M., Effects of a meal on haemodynamic function at rest and during exercise in patients with hypertrophic cardiomyopathy (1991) J Am Coll Cardiol, 18, pp. 429-436
Gilligan, D.M., Nihoyannopoulos, P., Chan, W.L., Oakley, C.M., Investigation of a hemodynamic basis for syncope in hypertrophic cardiomyopathy. Use of a head-up tilt test (1992) Circulation, 85, pp. 2140-2148
Guazzi, M., Maltagliati, A., Tamborini, G., Celeste, F., Pepi, M., Muratori, M., Berti, M., Guazzi, M.D., How the left and the right sides of the heart as well as pulmonary venous drainage adapt to an increasing degree of head-up tilting in hypertrophic cardiomyopathy: Differences from the normal heart (2000) J Am Coll Cardiol, 36, pp. 185-193
Abboud, F. M., Ventricular syncope: Is the heart a sensory organ? (1989) N Engl J Med, 320, pp. 390-39
Maron, B. J., Epstein, S. E., Hypertrophic cardiomyopathy: A discussion of nomenclature (1979) Am J Cardiol, 43, pp. 1242-1244
Liu, J. E., Hahn, R. T., Stein, K. M., Markowitz, S. M., Okin, P. M., Devereux, R. B., Lerman, B. B., Left ventricular geometry and function preceding neurally mediated syncope (2000) Circulation, 101, pp. 777-783
Sahn, D. J., DeMaria, A., Kisslo, J., Weiman, A., Recommendations regarding quantitation in M-mode echocardiography: Results of a survey of echocardiographic measurements (1978) Circulation, 58, pp. 1072-1083
Cohen, G. I., Pietrolungo, J. F., Thomas, J. D., Klein, A. L., A practical guide to assessment of ventricular function using Doppler echocardiography (1996) J Am Coll Cardiol, 27, pp. 1753-1760
Nienaber, C. A., Hiller, S., Spielmann, R. P., Geiger, M., Kuck, K. -H., Syncope in hypertrophic cardiomyopathy: Multivariate analysis of prognostic determinants (1995) J Am Coll Cardiol, 15, pp. 948-955
Gwathmey, J. K., Warren, S. E., Briggs, G. M., Copelas, L., Feldman, M. D., Phillips, P. J., Callahan M., Jr., Morgan, J. P., Diastolic dysfunction in hypertrophic cardiomyopathy. Effect on active force generation during systole (1991) J Clin Invest, 87, pp. 1023-1031
Hargreaves, A. D., Muir, A. L., Lack of variation in venous tone potentiates vasovagal syncope (1992) Br Heart J, 67, pp. 486-490
Sneddon, J. F., Counihan, P. J., Bashir, Y., Haywood, G. A., Ward, D. E., Camm, A. J., Impaired immediate vasoconstrictor responses in patient with recurrent neurally mediate vasovagal syncope (1993) Am J Cardiol, 71, pp. 72-76
Thomson, H. L., Wright, K., Frenneaux, M., Baroreflex sensitivity in patients with vasovagal syncope (1997) Circulation, 95, pp. 395-400
Leonelli, F. M., Wang, K., Evans, J. M., Patwardhan, A. R., Ziegler, M. G., Natale, A., Kim, C. S., Knapp, C. F., False positive head-up tilt test: Hemodynamic and neurohumoral profile (2000) J Am Coll Cardiol, 35, pp. 188-193
Frenneaux, M. P., Counihan, P. J., Caforio, A. L. P., Chikamori, T., McKenna, W. J., Abnormal blood pressure response during exercise in hypertrophic cardiomyopathy (1990) Circulation, 82, pp. 1995-2002
Gilligan, D. M., Chan, W. L., Ang, E. L., Oakley, C. M., Effects of a meal on haemodynamic function at rest and during exercise in patients with hypertrophic cardiomyopathy (1991) J Am Coll Cardiol, 18, pp. 429-436
Gilligan, D. M., Nihoyannopoulos, P., Chan, W. L., Oakley, C. M., Investigation of a hemodynamic basis for syncope in hypertrophic cardiomyopathy. Use of a head-up tilt test (1992) Circulation, 85, pp. 2140-2148
Myopia and IOP
This study was designed to investigate whether, in patients with hypertrophic cardiomyopathy (HC), tilt-induced volume unloading triggers a peripheral reflex similar to that seen in patients with a history of vasovagal syncope or rather acts through an intrinsic cardiac mechanism secondary to diastolic dysfunction. Thirty-seven patients with HC (10 with and 27 without a history of syncope), 10 patients with vasovagal syncope, and 9 controls underwent 70 head-up tilt for 45 minutes during continuous radionuclide monitoring of left ventricular function. We focused on the initial 5 minutes into the tilt test, well before symptoms occurred, to exclude that the observed hemodynamic changes were the consequence rather than the cause of syncope. HC patients with previous syncope and vasovagal patients experienced significant hypotension after the initial 5 minutes of tilt. Only HC patients with a history of syncope had a significant decrease in cardiac output, which began at the initial stage of the test. Systemic vascular resistance decreased in vasovagal patients, but increased in the HC syncopal group. Baseline peak filling rate was lower (2. 4 +/- 0. 5 vs 3. 3 +/- 1. 1 stroke counts/s, p = 0. 03) and a "pseudonormal" or a restrictive pattern of left ventricular filling was more frequent (70% vs 26%, p = 0. 02) in HC patients with than without a history of syncope. Thus, significant hypotension or frank syncope during orthostatic stress in HC patients with a history of syncope is due to an early decrease in cardiac output, which occurs well before the onset of symptoms; such impaired hemodynamic adaptation seems to be related to diastolic dysfunction. (C) 2002 by Excerpts Medica, Inc
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