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Disorders of Synchronization of Blood Pressure and Heart Rate Precede the Development of Vasovagal Syncope during Orthostasis

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Abstract

The goal of the present study was to identify the possible disturbances in the synchronization of spontaneous fluctuations in arterial pressure (AP) and heart rate (HR) at the frequency of baroreflex waves (~0.1 Hz) in patients prone to vasovagal fainting. In healthy volunteers and patients diagnosed with vasovagal syncope, AP (photo-compensation method) and ECG were continuously recorded, first in a horizontal position, and then during a passive orthostatic test (60°) lasting for 40 min. According to the results of the test, all patients were divided into two groups: subjects with a positive (development of the presyncopal or syncopal states) and a negative result of the orthostatic test. These groups of patients did not differ from each other and from the control group in terms of baseline AP and HR. The values of the phase synchronization index (PSI) of AP and HR were calculated in the frequency range from 0.02 to 0.8 Hz within 10-min recording intervals in the horizontal position and at the initial stage of orthostasis (starting from the second minute after the transition to the vertical position). Initially, all three groups had a distinct peak at the frequency of ~0.1 Hz in the PSI spectra. In the control group and in patients with a negative orthostatic result, a transition to the state of orthostasis was accompanied by an increase in the PSI in this frequency domain, in contrast to the patients with a positive orthostatic test, in which the PSI did not increase. Thus, the lack of amplification of phase synchronization of AP and HR at the early stage of orthostatic test is associated with the subsequent decompensation of hemodynamics and the development of syncope.

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Funding

This study was performed in the framework of the Plan for the Fundamental Research of the Institute of Biomedical Problems, Russian Academy of Sciences, Moscow, and was supported by the Russian Foundation for Basic Research (project no. 17-04-01943).

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Authors and Affiliations

  1. Institute of Biomedical Problems, Russian Academy of Sciences, Moscow, Russia

    A. S. Borovik, V. O. Negulyaev, O. S. Tarasova & O. L. Vinogradova

  2. Moscow State University, Moscow, Russia

    V. O. Negulyaev, O. S. Tarasova & O. L. Vinogradova

  3. National Medical Research Center of Cardiology, Ministry of Health of the Russian Federation, Moscow, Russia

    G. I. Kheymets, A. V. Pevzner, V. V. Ermishkin, N. E. Zyuzina & A. N. Rogoza

Authors
  1. A. S. Borovik
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  2. V. O. Negulyaev
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  3. O. S. Tarasova
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  4. G. I. Kheymets
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  5. A. V. Pevzner
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  6. V. V. Ermishkin
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  7. N. E. Zyuzina
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  8. A. N. Rogoza
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  9. O. L. Vinogradova
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Corresponding author

Correspondence to A. S. Borovik.

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Conflict of interests. The authors declare that they have no obvious or potential conflict of interest related to the publication of this article.

Statement of compliance with standards of research involving humans as subjects. The experiments were performed in accordance with the statement of ethical principles for biomedical research of the Declaration of Helsinki 1964 and its subsequent updates and were approved by the local Biomedical Ethical Committee of the National Medical Research Center of Cardiology, Ministry of Health of the Russian Federation, Moscow. Each participant was signed the written informed consent after an explanation of the potential risks, advantages, and specificity of the experiment.

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Translated by I. Matiulko

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Borovik, A.S., Negulyaev, V.O., Tarasova, O.S. et al. Disorders of Synchronization of Blood Pressure and Heart Rate Precede the Development of Vasovagal Syncope during Orthostasis. Hum Physiol 45, 405–411 (2019). https://doi.org/10.1134/S0362119719040029

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  • DOI: https://doi.org/10.1134/S0362119719040029

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