Article
Geriatrics & Gerontology
Kate Doyle, Amanda Lavan, Rose-Anne Kenny, Robert Briggs
Summary: This study found a positive association between delayed blood pressure recovery at 30, 60, and 90 seconds and the risk of fracture in community-dwelling older adults.
JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION
(2021)
Review
Clinical Neurology
Francesca Baschieri, Maria Vitiello, Pietro Cortelli, Giovanna Calandra-Buonaura, Francesca Morgante
Summary: Autonomic dysfunction is frequently observed in patients with PSP, but objective testing does not always reflect actual autonomic impairment.
JOURNAL OF NEUROLOGY
(2023)
Editorial Material
Cardiac & Cardiovascular Systems
Fabian Leys, Alessandra Fanciulli
Summary: This editorial discusses the association between hypotension and reflex syncope, based on the findings of the SynABPM 1 study.
EUROPEAN HEART JOURNAL
(2022)
Article
Peripheral Vascular Disease
Jin-woo Park, Luis E. Okamoto, Sung-hwan Kim, Seol-hee Baek, Joo Hye Sung, Namjoon Jeon, Alfredo Gamboa, Cyndya A. Shibao, Andre Diedrich, Byung-jo Kim, Italo Biaggioni
Summary: This study found that Valsalva maneuver responses can help identify patients who require prolonged head-up tilt table test to diagnose late-onset orthostatic hypotension (dOH). Patients with late-onset dOH had lower baseline systolic blood pressure changes at late phase 2, lower heart rate difference between baseline and phase 3, lower Valsalva ratio, and longer pressure recovery time (PRT) at phase 4 compared to controls. Long PRT and short increment HRVM3 can assist in identifying patients with late-onset dOH.
Article
Geriatrics & Gerontology
Laura Perez-Denia, Paul Claffey, Lisa Byrne, Ciara Rice, Rose Anne Kenny, Ciaran Finucane
Summary: Multimorbidity has a negative impact on cerebral and peripheral hemodynamics during standing in older patients, especially in females. This study demonstrates the feasibility of using near-infrared spectroscopy in a clinical context and provides insights for the development of clinical management strategies targeting faints and falls.
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY
(2022)
Article
Clinical Neurology
Guillaume Lamotte, Makoto Takahashi, Tianxia Wu, Patricia Sullivan, Jamie Cherup, Courtney Holmes, David S. Goldstein
Summary: Analyzing data from 72 patients with LBnOH, it was found that the severity of orthostatic hypotension is associated with baroreflex dysfunction and sympathetic noradrenergic deficiency, but the correlation varies among individual patients.
CLINICAL AUTONOMIC RESEARCH
(2021)
Article
Clinical Neurology
Xiaofan Xue, Anqi Huang, Jingrong Zeng, Haixia Song, Yingqi Xing, Piu Chan, Erhe Xu, Lichun Zhou
Summary: Patients with Parkinson's disease (PD) accompanied by orthostatic hypotension (OH) exhibit poor memory function, possibly due to decreased metabolic function in specific medial temporal lobes and impaired dynamic cerebral autoregulation ability.
FRONTIERS IN NEUROLOGY
(2023)
Review
Clinical Neurology
Alejandra Gonzalez-Duarte, Aditi Varma-Doyle, Roy Freeman
Summary: PAF is a peripheral autonomic neurodegenerative disease caused by alpha-synuclein deposition, with chronic features of autonomic failure. Diagnostic biomarkers include skin immunohistochemistry for alpha-synuclein and measuring cerebrospinal fluid alpha-synuclein oligomers. A considerable number of PAF patients may convert to a central alpha-synucleinopathy.
CURRENT OPINION IN NEUROLOGY
(2021)
Article
Chemistry, Analytical
Xina Quan, Junjun Liu, Thomas Roxlo, Siddharth Siddharth, Weyland Leong, Arthur Muir, So-Min Cheong, Anoop Rao
Summary: This paper reviews recent advances in non-invasive blood pressure monitoring and introduces a novel algorithm-based blood pressure sensor that uses machine-learning techniques to extract blood pressure values from pulse waveform shapes. The preliminary studies showed promising results in various patient populations, highlighting the accuracy and limitations of this capacitive-based technology in hospitals and communities.
Article
Allergy
Paul J. Turner, Monica Ruiz-Garcia, Nandinee Patel, Goncalo Abrantes, Sarah Burrell, Marta Vazquez-Ortiz, Isabel Skypala, Stephen R. Durham, Robert J. Boyle
Summary: Progressive or new-onset symptoms after the initial allergic reaction at OFC are common in peanut-allergic individuals, with approximately 27% experiencing symptoms >= 1 hour after the reaction, some of which may be temporally associated with food consumption, including orthostatic hypotension.
CLINICAL AND EXPERIMENTAL ALLERGY
(2021)
Article
Clinical Neurology
Tomotaka Shiraishi, Tadashi Umehara, Hisayoshi Oka, Atsuo Nakahara, Takeo Sato, Hiromasa Matsuno, Teppei Komatsu, Shusaku Omoto, Hidetomo Murakami, Yasuyuki Iguchi
Summary: This study revealed that patients with Parkinson's disease who had delayed orthostatic hypotension (DOH) tended to have more severe hyposmia compared to patients without orthostatic hypotension (OH). Additionally, relatively preserved peripheral sympathetic nervous system function in patients with DOH suggests that DOH might be an early and milder form of OH in Parkinson's disease.
CLINICAL AUTONOMIC RESEARCH
(2021)
Article
Endocrinology & Metabolism
Kazuhiro Sugimoto, Hirozumi Miyaoka, Takashi Sozu, Naohiro Sekikawa, Ryota Wada, Yuko Watanabe, Akira Tamura, Toshiro Yamazaki, Setsu Ohta, Susumu Suzuki
Summary: This study found that decreased CVRR at rest and during deep breathing was associated with lower body mass index, skeletal mass index, knee strength, and a higher proportion of impaired standing balance among non-elderly inpatients with diabetes.
JOURNAL OF DIABETES INVESTIGATION
(2023)
Article
Chemistry, Analytical
Anoop Rao, Fatima Eskandar-Afshari, Ya'el Weiner, Elle Billman, Alexandra McMillin, Noa Sella, Thomas Roxlo, Junjun Liu, Weyland Leong, Eric Helfenbein, Alan Walendowski, Arthur Muir, Alexandria Joseph, Archana Verma, Chandra Ramamoorthy, Anita Honkanen, Gabrielle Green, Keith Drake, Rathinaswamy B. Govindan, William Rhine, Xina Quan
Summary: In this article, a non-invasive wearable device is introduced, which can continuously monitor blood pressure without the need for external calibration. The device is easy to operate and has been proven to be accurate in measuring blood pressure in critically-ill infants.
Article
Medicine, General & Internal
Ekrem Yasa, Theodoros Intzilakis, Fabrizio Ricci, Olle Melander, Viktor Hamrefors, Richard Sutton, Artur Fedorowski
Summary: The objective of this study was to explore the outcomes of primary vs. delayed implantable cardiac monitors (ILR) implantation after an initial syncope evaluation. The study found that primary ILR implantation was associated with more positive results from cardiovascular autonomic testing (CAT) compared to delayed ILR implantation. However, there were no differences between the two groups in terms of negative ILR monitoring and pacemaker implantations.
JOURNAL OF CLINICAL MEDICINE
(2022)
Article
Medicine, General & Internal
Francesco Vasile, Luigi La Via, Paolo Murabito, Stefano Tigano, Federica Merola, Tiziana Nicosia, Giuseppe De Masi, Andrea Bruni, Eugenio Garofalo, Filippo Sanfilippo, Kassiani Theodoraki, Chun Yang
Summary: This study aimed to investigate the prevalence of perioperative hypotension after spinal anesthesia for cesarean section and its correlation with neonatal well-being. Continuous non-invasive hemodynamic monitoring allowed for early detection and prompt treatment of maternal hypotension, resulting in satisfactory outcomes for neonatal health.
JOURNAL OF CLINICAL MEDICINE
(2023)
Review
Cardiac & Cardiovascular Systems
Vincenzo Russo, Erika Parente, Antonella Groppelli, Giulia Rivasi, Marco Tomaino, Alessio Gargaro, Daniele Giacopelli, Andrea Ungar, Gianfranco Parati, Artur Fedorowski, Richard Sutton, J. Gert van Dijk, Michele Brignole
Summary: This review discusses the timing of tilt-induced asystole and loss of consciousness (LOC) in tilt-testing methodology. The commonly used Italian protocol is not always followed strictly, allowing for reassessment of the incidence of asystole during early tilt-down compared to late, established LOC. Asystole is less common in early tilt down and decreases with increasing age, but more common if LOC is established as the test-end point, and it is age-independent. The review also highlights the usefulness of asystole occurrence as a guide for pacemaker therapy in highly symptomatic older vasovagal syncope patients.
Article
Cardiac & Cardiovascular Systems
Carlo Fumagalli, Martina Rafanelli, Michele Brignole, Caterina Guarducci, Niccolo Bettoni, Giulia Rivasi, Paolo Pieragnoli, Giuseppe Ricciardi, Luca Checchi, Marco Gambardella, Flavia Casolaro, Giuseppe Paolisso, Raffaele Marfella, Giuseppe Signoriello, Niccolo Marchionni, Andrea Ungar, Celestino Sardu
Summary: This retrospective study reviewed 55 patients with syncope and bifascicular block (BFB) who received implantable cardiac monitors (ICM) from 2012 to 2020. The results showed that 36.3% of patients experienced syncope during follow-up, with 10.9% classified as arrhythmic syncope, and the incidence of syncope increased with age. 14 patients (25.5%) underwent pacemaker implantation, which was more frequent in patients aged 75 years and older.
INTERNATIONAL JOURNAL OF CARDIOLOGY
(2023)
Review
Cardiac & Cardiovascular Systems
Michele Brignole, Franco Cecchi, Aris Anastasakis, Lia Crotti, Jean Claude Deharo, Perry M. Elliott, Artur Fedorowski, Juan Pablo Kaski, Giuseppe Limongelli, Martin S. Maron, Iacopo Olivotto, Steve R. Ommen, Gianfranco Parati, Win Shen, Andrea Ungar, Arthur Wilde
Summary: Syncopal events in patients with hypertrophic cardiomyopathy (HCM) are vital considerations for risk stratification and ICD implantation, but the cause of syncope is often under-investigated or unexplained. Current syncope guidelines lack a detailed definition of unexplained syncope. To address this gap, an international panel of experts in syncope and HCM wrote a consensus document to provide practical guidance for the diagnosis and management of syncope in HCM patients.
INTERNATIONAL JOURNAL OF CARDIOLOGY
(2023)
Article
Cardiac & Cardiovascular Systems
Frederik Jorrit de Lange, Willem Petrus Merijn Emmanuel Hofland, Alessio Ferrara, Alessio Gargaro, Michele Brignole, Jan Gerrit van Dijk
Summary: In this study, a novel, practical, and inexpensive method called Open-Access-Video-TTT was described, which enables the addition of video recording during tilt table testing (TTT) without the need for an electroencephalogram (EEG) machine.
Article
Medicine, General & Internal
Vincenzo Russo, Erika Parente, Angelo Comune, Nunzia Laezza, Anna Rago, Paolo Golino, Gerardo Nigro, Michele Brignole
Summary: This study compared the positivity rate and type of responses in patients with classical and non-classical vasovagal syncope (VVS) using NTG-potentiated HUTT. The results showed that the positivity rate of HUTT was significantly higher in patients with classical VVS compared to those with non-classical VVS. Non-classical VVS patients were more likely to have a cardioinhibitory response and a history of traumatic syncope. Male sex, classical VVS, history of traumatic syncope, and use of diuretics were independent predictors of HUTT positivity.
EUROPEAN JOURNAL OF INTERNAL MEDICINE
(2023)
Correction
Cardiac & Cardiovascular Systems
Giuseppe Mascia, Lia Crotti, Antonella Groppelli, Marco Canepa, Andrea Carlo Merlo, Stefano Benenati, Paolo Di Donna, Roberta Della Bona, Davide Soranna, Antonella Zambon, Italo Porto, Iacopo Olivotto, Gianfranco Parati, Michele Brignole, Franco Cecchi
INTERNATIONAL JOURNAL OF CARDIOLOGY
(2023)
Review
Cardiac & Cardiovascular Systems
Michele Brignole, Tolga Aksu, Leonardo Calo, Philippe Debruyne, Jean Claude Deharo, Alessandra Fanciulli, Artur Fedorowski, Piotr Kulakowski, Carlos Morillo, Angel Moya, Brian Olshansky, Roman Piotrowski, Sebastian Stec, Dan Wichterle
Article
Cardiac & Cardiovascular Systems
Nicola Bottoni, Fabio Quartieri, Matteo Iori, Antonella Battista, Alessandro Navazio, Michele Brignole
Summary: This study analyzed the outcomes of AF ablation in patients from 2002 to 2021 at the cardiology department of Reggio Emilia hospital. The follow-up was conducted until the second half of 2022. The findings showed that despite one or more ablations, the long-term recurrence rate of symptomatic AF remained relatively high, but ablation was able to reduce the rate of symptomatic recurrences and delay their occurrence.
Article
Cardiac & Cardiovascular Systems
Vincenzo Russo, Erika Parente, Marco Tomaino, Angelo Comune, Antonella Sabatini, Nunzia Laezza, Domenico Carretta, Gerardo Nigro, Anna Rago, Paolo Golino, Michele Brignole
Summary: This study compared the effectiveness of the traditional nitroglycerin head-up tilt test (HUTT) and a shorter duration fast protocol in diagnosing cases of hypotension and bradycardia. The results showed that the fast protocol had a similar positivity rate and hemodynamic response distribution compared to the traditional protocol. Therefore, the fast protocol can be used as an alternative to the traditional protocol.
EUROPEAN HEART JOURNAL
(2023)
Review
Engineering, Biomedical
Michele Brignole, Giulia Rivasi, Artur Fedorowski, Marcus Stahlberg, Antonella Groppelli, Andrea Ungar
Summary: The efficacy of reflex syncope treatment is mainly related to its underlying mechanism rather than its cause or clinical presentation. This article discusses the methodology and diagnostic criteria of tests to identify hypotensive and bradycardic phenotypes. The importance of investigating the mechanism of reflex syncope is highlighted, particularly in patients with severe recurrent episodes, in order to develop a personalized treatment strategy.
EXPERT REVIEW OF MEDICAL DEVICES
(2023)
Article
Cardiac & Cardiovascular Systems
Bashaaer Sharad, Giulia Rivasi, Viktor Hamrefors, Madeleine Johansson, Andrea Ungar, Richard Sutton, Michele Brignole, Gianfranco Parati, Artur Fedorowski
Summary: This study compared ambulatory blood pressure monitoring data between patients with reflex syncope and a control group. The findings showed that patients with reflex syncope had lower 24-hour systolic blood pressure, higher 24-hour diastolic blood pressure, and more frequent daytime drops in systolic blood pressure.
JOURNAL OF THE AMERICAN HEART ASSOCIATION
(2023)
Article
Cardiac & Cardiovascular Systems
Nicola Bottoni, Paolo Donateo, Luca Rossi, Michele Malagu, Luca Tomasi, Fabio Quartieri, Andrea Biagi, Matteo Iori, Giacomo Mugnai, Antonella Battista, Stefano Clo, Michele Brignole, Matteo Bertini
Summary: Using intracardiac echocardiography (ICE) during transseptal catheterization (TSC) procedures for supraventricular arrhythmias significantly reduces periprocedural complications and complications specifically related to TSC. ICE support is associated with a lower complication rate, demonstrating its importance in left atrial arrhythmia ablation procedures.
JOURNAL OF CARDIOVASCULAR DEVELOPMENT AND DISEASE
(2023)
Letter
Cardiac & Cardiovascular Systems
Michele Brignole
Article
Cardiac & Cardiovascular Systems
Vincenzo Russo, Erika Parente, Angelo Comune, Nunzia Laezza, Anna Rago, Gerardo Nigro, Michele Brignole
Summary: This study compared the clinical characteristics and response to head-up tilt test (HUTT) between situational syncope (SS) and vasovagal syncope (VVS). The results showed that compared to VVS, patients with SS have different clinical characteristics and a higher prevalence of hypotensive drugs. The positivity rate of HUTT is high and similar to that of VVS, although patients with SS show a higher prevalence of hypotensive responses.
Article
Peripheral Vascular Disease
Antonella Groppelli, Martina Rafanelli, Giuseppe Dario Testa, Samuele Agusto, Giulia Rivasi, Erika Carbone, Davide Soranna, Antonella Zambon, Paolo Castiglioni, Andrea Ungar, Michele Brignole, Gianfranco Parati
Summary: Compared with conventional methods, the study found that RootiRx (R) was unable to detect rapid drops in blood pressure occurring during impending reflex syncope, and thus cannot be used as a diagnostic tool for hypotensive syncope. However, the RRI mean values and LF/HF power ratios obtained with RootiRx (R) were consistent with those obtained using conventional methods.
JOURNAL OF HUMAN HYPERTENSION
(2023)
