Cited by 132Cardiovascular Syncope and Autonomic DisordersHeart Rate Variability and Autonomic ControlCardiac electrophysiology and arrhythmias

The DOI matches its Crossref record; 22 of the 22 references it cites were found in a registry or an index.

Neurally mediated syncope detected by carotid sinus massage and head-up tilt test in sick sinus syndrome

Brignole, Michele, Menozzi, Carlo, Gianfranchi, Lorella, Oddone, Daniele, Lolli, Gino, Bertulla, Antonio·1991·The American Journal of Cardiology

DOI 10.1016/0002-9149(91)90491-3

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Abstract

It is generally accepted that a positive response to carotid sinus massage (CSM) or head-up tilt (HUT) in patients affected by syncope suggests a reflex cause of the syncope. To study the role of the autonomic nervous system in causing syncope in the sick sinus syndrome (SSS), CSM and HUT were performed in 35 consecutive patients (20 men, mean age 70 +/- 9 years) with syncope and SSS. Results were compared with those in 35 patients affected by syncope that, despite careful cardiovascular and neurologic examination, were of uncertain origin (21 men; mean age 68 +/- 9 years) and with those of 35 subjects without syncope (20 men; mean age 69 +/- 10). All patients underwent CSM in the supine and standing positions for 10 seconds and HUT to 60 degrees for 60 minutes. In the patients with SSS, the full reproduction of spontaneous symptoms by CSM occurred in 21 (60%) and by HUT, in 19 (54%). At least 1 test was positive in 28 patients (80%): cardioinhibitory or mixed responses in 69%, vasodepressor responses in 11%. The percentages of positive tests in the patients with syncope of uncertain origin were similar to or slightly less than those of patients with SSS (CSM 63%, HUT 26%, overall 74%) with cardioinhibitory or mixed responses in 54% and vasodepressor in 20% (p less than 0.05). In control subjects, syncope was induced by CSM in 1 (3%) and by HUT in 2 (6%); overall positivity was 9%. In conclusion, in most patients affected by syncope and SSS, an abnormal neural reflex probably plays a major role in causing syncope.(ABSTRACT TRUNCATED AT 250 WORDS)

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Authors: Brignole, M., Menozzi, C., Gianfranchi, L., Oddone, D., Lolli, G., & Bertulla, A.
Affiliations: Presidio Ospedaliero (IT)
ORCID: Brignole, Michele
Venue: The American Journal of Cardiology
Publisher: Elsevier BV
Published: 1991-10
Volume: 68
Issue: 10
Pages: 1032-1036
ISSN: 0002-9149 (ISSN-L)
DOI: 10.1016/0002-9149(91)90491-3
OpenAlex: W2127225262
Cited by: 132
References: 22
Citations by year: 2025: 1 · 2023: 2 · 2022: 3 · 2021: 2 · 2020: 2 · 2019: 3 · 2018: 5 · 2016: 2 · 2014: 2 · 2013: 5 · 2012: 6
FWCI: 4.36
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: The American Journal of Cardiology (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Syncope and Autonomic Disorders
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
Keywords: syncope, sick sinus syndrome, carotid sinus massage, head-up tilt, neurogenic syncope, autonomic nervous system, cardioinhibitory response, vasodepressor response, neural reflexes
MeSH terms: Aged, Autonomic Nervous System, Carotid Sinus, Female, Humans, Male, Posture, Reflex, Sick Sinus Syndrome, Syncope

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Neurally mediated syncope detected by carotid sinus massage and head-up tilt test in sick sinus syndrome

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