Catecholamine Plasma Levels during the Head-up Tilt Test in Patients with Vasovagal Syncope
PLAZMATICKÉ HLADINY KATECHOLAMÍNOV POČAS TESTU NA NAKLONENEJ ROVINE U PACIENTOV S VAZOVAGÁLNOU SYNKOPOU
Východisko.
Test na naklonenej rovine (head-up tilt test-HUT):
umožňuje diagnostikovať vazovagálnu synkopu. Cieľom práce bolo sledovať zmeny plazmatických hladín katecholamínov počas HUT a overiť ich význam v pato- genéze vazovagálnej synkopy.Metódy a výsledky. U 25 pacientov so synkopou nejasnej etiológie boli počas HUT sledované hladiny noradre- nalínu, adrenalínu a dopamínu. U 15 pacientov (8 mužov, 7 žien, priemerný vek 34,3 roka) bol HUT pozitívny, kontrolnú skupinu tvorilo 10 pacientov s negatívnym HUT (4 muži, 6 žien, priemerný vek 41,1 roka). Hladiny katecholamínov boli stanovené metódou vysokoúčinnej kvapalinovej chromatografie v 0. minúte, 5. minúte a pri ukončení testu (tj. pri rozvoji synkopy alebo v 45. minúte). Pri porovnaní t-testom neboli zistené štatisticky významné rozdiely medzi skupinou s vazovagálnou synkopou a kontrolnou skupinou. Noradrenalín 0. min 186,4 ± 61,6 pg/ml vs 190,5 ± 67,4 pg/ml (n.s.), 5. min 506,3 ± 178,9 pg/ml vs 566,8 ± 195,6 pg/ml (n.s.), koniec testu 457,3 ± 154,1 pg/ml vs 352,3 ± 169,9 pg/ml (n.s.). Adrenalín 0. min 54,0 ± 12,6 pg/ml vs 54,9 ± 13,6 pg/ml (n.s.), 5. min 114,3 ± 15,6 pg/ml vs 128,1 ± 41,0 pg/ml (n.s.), koniec testu 98,2 ± 40,6 pg/ml vs 78,3 ± 31,2 pg/ml (n.s.). Dopamín 0. min 113,9 ± 36,5 pg/ml vs 158,4 ± 67,2 pg/ml (n.s.), 5. min. 318,1 ± 72,7 pg/ml vs 328,5 ± 119,7 pg/ml (n.s.), koniec testu 279,4 ± 93,8 pg/ml vs 231,7 ± 98,5 pg/ml (n.s.).Závery. Plazmatické hladiny katecholamínov sa u pacientov s vazovagálnou synkopou nelíšili od kontrolnej skupiny. Význam katecholamínov v patogenéze vazovagálnej synkopy preto nemôžeme potvrdiť.
Klíčová slova:
Test na naklonenej rovine, vazovagálna synkopa, katecholamíny.
Authors:
R. Rybár; P. Mitro; E. Rybárová 1; D. Trejbal; I. Lazúrová
Authors place of work:
II. interná klinika, LF UPJŠ, FNsP, Košice, 1 Oddelenie klinickej biochémie, FNsP, Košice
Published in the journal:
Čas. Lék. čes. 1999; : 18-20
Category:
Summary
Background.
The head-up tilt test (HUT) makes it possible to diagnose vasovagal syncope. The objective of the trial was to follow up changes of catecholamine plasma levels during HUT and test their importance in the pathogenesis of vasovagal syncope.and dopamine levels were followed up. In 125 patients (8 men and 7 women, mean age 34.3 years) HUT was positive. The control group was formed by 10 patients with negative HUT (4 men, 6 women, mean age 41.1 years). The catecholamine levels were assessed by the method of high resolution liquid chromatography during minutes 0, 5 and after completion of the test (i.e. during development of the syncope or the 45th minute). On comparison by the t-test no statistically significant difference between the group with vasovagal syncope and the control group was found. Noradrenalin 0 min: 186.4 ± 61.6 pg/ml vs. 190.5 ± 67.4 pg/ml (n.s.), 5th min. 506.3 ± 178.9 pg/ml vs. 566.8 ± 195.6 pg/ml (n.s.), end of test 457.3 ± 154.1 pg/ml vs. 352.3 ± 169.9 pg/ml (n.s.). Adrenalin 0 min. 54.0 ± 12.6 pg/ml vs. 54.9 ± 13.6 pg/ml (n.s.), 5th min. 114.3 ± 35.6 pg/ml vs. 128.1 ± 41.0 pg/ml n.s., end of test 98.2 ± 40.6 vs. 783 ± 31.2 pg/ml (n.s.). Dopamine 0 min. 113.9 ± 36.5 pg/ml vs. 158.4 ± 67.2 pg/ml (n.s.), 5th min. 318.1 ± 72.7 vs. 328.5 ± 119.7 pg/ml (n.s.), end of test 279.4 ± 93.8 pg/ml vs. 231.7 ± 98.5 pg/ml (n.s.).Conclusions. Catecholamine plasma levels in patients with vasovagal syncope did not differ from the control group. The importance of catecholamines in the pathogenesis of vasovagal syncope thus cannot be confirmed.
Key words:
head-up tilt test, vasovagal syncope, catecholamines.
Štítky
Addictology Allergology and clinical immunology Angiology Audiology Clinical biochemistry Dermatology & STDs Paediatric gastroenterology Paediatric surgery Paediatric cardiology Paediatric neurology Paediatric ENT Paediatric psychiatry Paediatric rheumatology Diabetology Pharmacy Vascular surgery Pain management Dental HygienistČlánok vyšiel v časopise
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