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Clinical Autonomic Research

, Volume 25, Issue 6, pp 383–390 | Cite as

Simple cardiovagal and adrenergic function tests in carotid artery stenosis patients as a potential tool for determining a transient autonomic dysfunction

  • Viktor Švigelj
  • Matjaž Šinkovec
  • Viktor Avbelj
  • Roman Trobec
Research Article

Abstract

Purpose

The arterial baroreflex depends on the integrity of the afferent limb, which can be quantified using the baroreceptor’s sensitivity (BRS) during the Valsalva maneuver (VM). The aim of this study was to evaluate, using autonomic nervous system tests, the autonomic function in patients after a carotid artery angioplasty (CAS).

Methods

We evaluated the changes in blood pressure (BP) during the VM (Valsalva ratio, BRS, sympathetic indexes) in 41 patients with symptomatic, unilateral, internal carotid artery stenosis.

Results

The Valsalva ratio between the baseline and the post-procedural day (1.3 ± 0.1 vs 1.44 ± 0.3; P = 0.002) and the post-procedural day and a month later (1.44 ± 0.3 vs 1.3 ± 0.3; P = 0.0002) revealed significant differences. This was confirmed with a cardiovagal BRS test. However, the adrenergic BRS did not reveal any differences. Sympathetic indexes [BP fall (SI1) and recovery during phase 2 (SI2)] showed differences for the periods before and a day after the treatment (36.9 ± 18.0 vs 27.2 ± 21.4 and 7.1 ± 13.1 vs 3.0 ± 8.2, respectively; P = 0.004) and for SI1 a day and a month after the treatment (27.2 ± 21.4 vs 37.1 ± 21.8; P = 0.036). The dynamic ranges between S1 and S3 (the difference in the BP between the baseline and the end of phase 2) were also different (P = 0.007 and P = 0.044, respectively).

Conclusion

We found heterogeneous responses in the BP regulation obtained with the Valsalva maneuver in our patients; however, we could not confirm that CAS provoked any long-term autonomic dysfunction, except for 1 day after the procedure.

Keywords

Angioplasty Baroreflex Carotid stenosis Autonomic dysreflexia Valsalva maneuver 

Notes

Acknowledgments

This work was partly supported by the Slovenian Research Agency under Grant P2-0095.

Compliance with ethical standards

Conflict of interest

The authors declare no financial or other conflicts of interest.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • Viktor Švigelj
    • 1
  • Matjaž Šinkovec
    • 2
  • Viktor Avbelj
    • 3
  • Roman Trobec
    • 3
  1. 1.Neurological Intensive Care Unit, Division of Neurology, Department of Vascular Neurology and Intensive CareUniversity Medical Centre LjubljanaLjubljanaSlovenia
  2. 2.Division of Internal Medicine, Department of CardiologyUniversity Medical Centre LjubljanaLjubljanaSlovenia
  3. 3.Department of Communication SystemsJožef Stefan InstituteLjubljanaSlovenia

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