Neurally Mediated Syncope and Cardiac β-Adrenergic Receptor Function

Boh-Oka, Shin-Ichi; Ohmori, Hisashi; Kawabe, Tetuya; Tutiyama, Yasuko; Shimamoto, Yoriko; Shioji, S.; Obana, Masahiro; Satani, Osamu; Wanaka, Yoshio; Hamada, Masanori; Baba, Akira; Tsuda, Kazushi; Hano, Takuzo; Nishio, Ichiro

doi:10.1097/00005344-200110001-00016

Cited by 6 publications

(5 citation statements)

References 10 publications

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“…Cardiac 123 I‐MIBG imaging investigates the function and integrity of presynaptic nerve endings. Several studies have suggested that VVS is associated with abnormal cardiac 123 I‐MIBG scintigraphy . Kochiadakis et al reported that the H/M ratio was significantly lower in syncopal patients than in controls and that the WR was significantly higher.…”

Section: Discussionmentioning

confidence: 99%

“…Kochiadakis et al reported that the H/M ratio was significantly lower in syncopal patients than in controls and that the WR was significantly higher. Boh‐Oka et al investigated cardiac 123 I‐MIBG scintigraphies in nine VVS patients, and reported that eight of them showed reduced myocardial uptake. These reports could lend support to our results.…”

Section: Discussionmentioning

confidence: 99%

“…Several studies have suggested that VVS is associated with abnormal cardiac 123 I-MIBG scintigraphy. 16,20 Kochiadakis et al 16 reported that the H/M ratio was significantly lower in syncopal patients than in controls and that the WR was significantly higher. Boh-Oka et al 20 investigated cardiac 123 I-MIBG scintigraphies in nine VVS patients, and reported that eight of them showed reduced myocardial uptake.…”

Section: Usefulness Of Cardiac 123 I-mibg Scintigraphy In Vvs Patientsmentioning

confidence: 99%

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Cardiac Autonomic Dysfunction in Patients with Head‐up Tilt Test‐Induced Vasovagal Syncope

Shinohara

Ebata

Ayabe

et al. 2014

Pacing Clinical Electrophis

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Usefulness Of Cardiac 123 I-mibg Scintigraphy In Vvs Patientsmentioning

confidence: 99%

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Cardiac Autonomic Dysfunction in Patients with Head‐up Tilt Test‐Induced Vasovagal Syncope

Shinohara

Ebata

Ayabe

et al. 2014

Pacing Clinical Electrophis

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“…Particularly, beta‐blockers aim to reduce the sympathetic effect on the heart and are a recommended therapy for patients suffering from HFrEF. As a result, patients suffer from an iatrogenic chronotropic incompetence and reduced blood pressure, both relevant factors in the origin of syncopes . Furthermore, adrenergic receptors of the vasculature are key not only to cardiac syncopes but also to neurally mediated syncopes—not to differentiate in our cohort as we do not have any information on the origin .…”

Section: Discussionmentioning

confidence: 99%

Syncopes and clinical outcome in heart failure: results from prospective clinical study data in Germany

et al. 2020

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Aims Whereas syncopal episodes are a frequent complication of cardiovascular disorders, including heart failure (HF), little is known whether syncopes impact the prognosis of patients with HF. We aimed to assess the impact of a history of syncope (HoS) on overall and hospitalization-free survival of these patients. Methods and resultsWe pooled the data of prospective, nationwide, multicentre studies conducted within the framework of the German Competence Network for Heart Failure including 11 335 subjects. Excluding studies with follow-up periods <10 years, we assessed 5318 subjects. We excluded a study focusing on cardiac changes in patients with an HIV infection because of possible confounding factors and 849 patients due to either missing key parameters or missing follow-up data, resulting in 3594 eligible subjects, including 2130 patients with HF [1564 patients with heart failure with reduced ejection fraction (HFrEF), 314 patients with heart failure with mid-range ejection fraction, and 252 patients with heart failure with preserved ejection fraction (HFpEF)] and 1464 subjects without HF considered as controls. HoS was more frequent in the overall cohort of patients with HF compared with controls (P < 0.001)-mainly driven by the HFpEF subgroup (HFpEF vs. controls: 25.0% vs. 12.8%, P < 0.001). Of all the subjects, 14.6% reported a HoS. Patients with HFrEF in our pooled cohort showed more often syncopes than subjects without HF (15.0% vs. 12.8%, P = 0.082). Subjects with HoS showed worse overall survival [42.4% vs. 37.9%, hazard ratio (HR) = 1.21, 99% confidence interval (0.99, 1.46), P = 0.04] and less days alive out of hospital [HR = 1.39, 99% confidence interval (1.18, 1.64), P < 0.001] compared with all subjects without HoS. Patients with HFrEF with HoS died earlier [30.3% vs. 41.6%, HR = 1.40, 99% confidence interval (1.12, 1.74), P < 0.001] and lived fewer days out of hospital than those without HoS. We could not find these changes in mortality and hospital-free survival in the heart failure with mid-range ejection fraction and HFpEF cohorts. HoS represented a clinically high-risk profile within the HFrEF group-combining different risk factors. Further analyses showed that among patients with HFrEF with HoS, known cardiovascular risk factors (e.g. age, male sex, diabetes mellitus, and anaemia) were more prevalent. These constellations of the risk factors explained the effect of HoS in a multivariable Cox regression models. Conclusions In a large cohort of patients with HF, HoS was found to be a clinically and easily accessible predictor of both overall and hospitalization-free survival in patients with HFrEF and should thus routinely be assessed.

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“…For these reasons, IPR is used to treat salivation disorders and bronchial asthma, and it is used as a beta-adrenergic receptor agonist. 13,14 In the present study, IPR was administered to mice to release the secretory granules from submandibular gland acinar cells before irradiating them, so that the effect of irradiation on protein synthesis and secretion could be determined histochemically. Savage et al 15 exposed the submandibular glands of rats to a 10-Gy dose of X-ray, and noted marked morphological changes after 3 days, but not after 14 days.…”

Section: Discussionmentioning

confidence: 99%

Radioprotection of the murine submandibular gland by isoproterenol: autoradiography study with 3H-leucine

et al. 2004

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Irradiation of the salivary glands results in the generation of free radicals from metal ions present in the secretory granules of acinar cells, a process that is believed to exacerbate radiation damage to the salivary glands. We therefore conducted a comparative investigation of radiation damage to the acinar cells of murine submaxillary glands in which granule secretion had been induced, and used autoradiography to visualize the pathological changes. Male BALB/c mice, at 8 weeks of age, were divided into four groups: a no-isoproterenol (IPR) and no-irradiation group (group I), a no-IPR, irradiated group (group II), an IPR, no-irradiation group (group III), and an IPR, irradiated group (group IV). Intraperitoneal injections of IPR were used, and 3 h later, the submaxillary region was irradiated with X-rays at a dose of 10 Gy. Three days after the irradiation, 3H-leucine was administered, and submaxillary glands were removed at predetermined times. Thin sections were prepared, and light- and electron-microscope autoradiography was performed. The number of reduced silver particles per unit acinar cell area was determined by light-microscopic autoradiography, and the proportion of reduced silver particles in the rough endoplasmic reticulum, the Golgi apparatus, and secretion granules was determined by electron-microscopic autoradiography. The result indicated that the effects of the radiation on the secretory potential of the submaxillary glands were diminished in acinar cells with a higher secretory granule content.

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Neurally Mediated Syncope and Cardiac β-Adrenergic Receptor Function

Cited by 6 publications

References 10 publications

Cardiac Autonomic Dysfunction in Patients with Head‐up Tilt Test‐Induced Vasovagal Syncope

Cardiac Autonomic Dysfunction in Patients with Head‐up Tilt Test‐Induced Vasovagal Syncope

Syncopes and clinical outcome in heart failure: results from prospective clinical study data in Germany

Radioprotection of the murine submandibular gland by isoproterenol: autoradiography study with 3H-leucine

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