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Cited by 365Cardiovascular Syncope and Autonomic DisordersHeart Rate Variability and Autonomic ControlCardiovascular and exercise physiology

The DOI matches its Crossref record; 6 of the 6 references it cites were found in a registry or an index.

Syncope, cerebral perfusion, and oxygenation

Van Lieshout, Johannes J., Wieling, Wouter, Karemaker, John M., Secher, Niels H.·2003·Journal of Applied Physiology
DOI 10.1152/japplphysiol.00260.2002
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Abstract

During standing, both the position of the cerebral circulation and the reductions in mean arterial pressure (MAP) and cardiac output challenge cerebral autoregulatory (CA) mechanisms. Syncope is most often associated with the upright position and can be provoked by any condition that jeopardizes cerebral blood flow (CBF) and regional cerebral tissue oxygenation (cO 2 Hb). Reflex (vasovagal) responses, cardiac arrhythmias, and autonomic failure are common causes. An important defense against a critical reduction in the central blood volume is that of muscle activity (“the muscle pump”), and if it is not applied even normal humans faint. Continuous tracking of CBF by transcranial Doppler-determined cerebral blood velocity ( V mean ) and near-infrared spectroscopy-determined cO 2 Hb contribute to understanding the cerebrovascular adjustments to postural stress; e.g., MAP does not necessarily reflect the cerebrovascular phenomena associated with (pre)syncope. CA may be interpreted as a frequency-dependent phenomenon with attenuated transfer of oscillations in MAP to V mean at low frequencies. The clinical implication is that CA does not respond to rapid changes in MAP; e.g., there is a transient fall in V mean on standing up and therefore a feeling of lightheadedness that even healthy humans sometimes experience. In subjects with recurrent vasovagal syncope, dynamic CA seems not different from that of healthy controls even during the last minutes before the syncope. Redistribution of cardiac output may affect cerebral perfusion by increased cerebral vascular resistance, supporting the view that cerebral perfusion depends on arterial inflow pressure provided that there is a sufficient cardiac output.

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  • During phases of presyncope in orthostatic stress tests, probands appear to develop feelings described as distress or feeling uncomfortable in an ill-defined way.

    “At least during phases of presyncope in orthostatic stress tests, probands appear to develop feelings described as distress (Lagi et al., 2001) or “feeling uncomfortable in an ill-defined way” (Van Lieshout et al., 2003, p.835).”

    From The psychophysiology of blood-injection-injury phobia: Looking beyond the diphasic response paradigm (2010) · cites this paper as Van Lieshout et al., 2003

  • Reports of syncope induced by hypocapnia alone are rare or limited to special maneuvers that combine voluntary hyperventilation with straining and postural stress.

    “However, reports of syncope induced by hypocapnia alone a rare (e.g., David et al., 2003) or limited to special maneuvers that combine voluntary hyperventilation with straining and postural stress (the “fainting lark,” van Lieshout et al., 2003).”

    From The psychophysiology of blood-injection-injury phobia: Looking beyond the diphasic response paradigm (2010) · cites this paper as van Lieshout et al., 2003

  • At 50-60% reduction of cerebral blood flow, symptoms of mental confusion and problems with cerebral oxygenation set in.

    “At 50–60% reduction of CBF, symptoms of mental confusion and problems with cerebral oxygenation set in (van Lieshout et al., 2003).”

    From The psychophysiology of blood-injection-injury phobia: Looking beyond the diphasic response paradigm (2010) · cites this paper as van Lieshout et al., 2003

  • Prodromal experiences in orthostatic syncope include diffuse symptoms of epigastric discomfort, nausea, sweating, and the desire to sit down or leave the room in early stages, and later lightheadedness, fatigue, palpitations, and blurred vision through reduced retinal perfusion.

    “Prodromal experiences in orthostatic syncope have been described in detail by Van Lieshout et al. (2003). This involves diffuse symptoms of epigastric discomfort, nausea, sweating, and “the desire to sit down or leave the room” (p. 835) in early stages, and subsequent sensations of lightheadedness, fatigue, palpitations, and blurred vision through reduced retinal perfusion.”

    From The psychophysiology of blood-injection-injury phobia: Looking beyond the diphasic response paradigm (2010) · cites this paper as Van Lieshout et al. (2003)

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Research works printed but not linked: 177

  1. 10.1161/01.STR.20.1.45 · DOI
  2. 10.1161/hs1101.098356 · DOI
  3. 10.1046/j.1365-201X.1996.444165000.x · DOI
  4. Bakay L, 1952, Surg Gynecol Obstet, 95, 67
  5. 10.1113/jphysiol.1902.sp000911 · DOI
  6. 10.1111/j.1748-1716.1936.tb01458.x · DOI
  7. 10.1161/01.STR.17.5.913 · DOI
  8. Blaber AP, 2001, Aviat Space Environ Med, 72, 985
  9. 10.1177/014107689809100704 · DOI
  10. 10.1007/BF01958769 · DOI
  11. Borgia JF, 1975, J Occup Med, 17, 696
  12. 10.1053/eupc.2001.0190 · DOI
  13. 10.1203/00006450-199301000-00012 · DOI
  14. 10.1161/01.CIR.9.1.89 · DOI
  15. Burton RR, 1985, Aviat Space Environ Med, 56, 812
  16. 10.1007/BFb0027696 · DOI
  17. 10.1016/S0002-9343(99)80315-5 · DOI
  18. 10.1042/cs1010351 · DOI
  19. 10.1161/hc3301.094908 · DOI
  20. 10.1161/01.STR.28.6.1195 · DOI
  21. 10.1097/00004647-199611000-00021 · DOI
  22. 10.1046/j.1365-2281.1997.01414.x · DOI
  23. 10.1016/S0140-6736(73)90974-4 · DOI
  24. 10.3171/jns.1996.84.1.0079 · DOI
  25. 10.1136/jnnp.66.5.606 · DOI
  26. 10.1016/S0735-1097(02)01719-9 · DOI · Paper page
  27. 10.1152/jappl.1999.86.2.675 · DOI
  28. 10.3171/jns.1974.41.5.0597 · DOI
  29. 10.1046/j.1365-201X.2002.00953.x · DOI
  30. 10.1080/01616412.2000.11740679 · DOI
  31. 10.1007/BF02322258 · DOI
  32. 10.1161/01.STR.26.10.1801 · DOI
  33. 10.1161/01.STR.25.3.692 · DOI
  34. 10.1016/S0003-4975(10)62694-X · DOI
  35. 10.1001/archneurpsyc.1937.02260140137007 · DOI
  36. Folkow B., 1964, Circ Res, 15, 279
  37. 10.1152/ajpheart.1998.274.3.H1023 · DOI
  38. 10.1227/00006123-199305000-00006 · DOI
  39. 10.1053/eupc.2001.0155 · DOI
  40. 10.1097/00005373-199705001-00005 · DOI
  41. 10.1016/S0140-6736(51)91773-4 · DOI
  42. 10.1111/j.1540-8159.1998.tb00120.x · DOI
  43. Hamilton WF., 1948, Am J Physiol, 153, 309, 10.1152/ajplegacy.1948.153.2.309 · DOI
  44. Hamilton WF, 1943, Am J Physiol, 141, 42, 10.1152/ajplegacy.1944.141.1.42 · DOI
  45. 10.1161/01.RES.55.2.197 · DOI
  46. 10.1161/01.STR.31.7.1608 · DOI
  47. 10.1007/BF02317800 · DOI
  48. 10.1042/cs0970291 · DOI
  49. 10.1136/jnnp.28.5.449 · DOI
  50. 10.1007/978-1-4613-0333-6_15 · DOI
  51. Heistad DD, 1983, Handbook of Physiology. The Cardiovascular System. Peripheral Circulation and Organ Blood Flow., 137
  52. 10.1152/ajpheart.1978.235.5.H544 · DOI
  53. 10.1152/jappl.1996.81.1.413 · DOI
  54. Hellstrøm G, 1996, Cardiol Elderly, 4, 191
  55. 10.1152/ajpheart.1998.274.6.H2177 · DOI
  56. 10.1113/jphysiol.1897.sp000657 · DOI
  57. Holt JP., 1941, Am J Physiol, 134, 292, 10.1152/ajplegacy.1941.134.2.292 · DOI
  58. 10.1152/jappl.2001.90.5.1657 · DOI
  59. 10.1136/bmj.2.4728.382 · DOI
  60. 10.1161/hs1001.097225 · DOI
  61. 10.1046/j.1365-201x.2000.00757.x · DOI
  62. 10.1046/j.1365-2281.1999.00178.x · DOI
  63. 10.1152/jappl.1999.87.5.1604 · DOI
  64. 10.1046/j.1365-201X.1998.0280f.x · DOI
  65. 10.1007/BF00964132 · DOI
  66. 10.1161/01.RES.25.1.77 · DOI
  67. 10.1093/bja/87.2.212 · DOI
  68. 10.1007/BF00254515 · DOI
  69. 10.1042/cs0910193 · DOI
  70. 10.1097/00000542-199905000-00016 · DOI
  71. 10.1152/jappl.1992.72.3.1123 · DOI
  72. 10.1111/j.1475-097X.1993.tb00333.x · DOI
  73. 10.1056/NEJM200012213432507 · DOI
  74. Kellie G., 1822, Transactions of the Medico-Chirurgical Society of Edinburgh, 1, 84
  75. 10.1172/JCI101680 · DOI
  76. 10.1016/0002-9343(64)90010-5 · DOI
  77. 10.1111/jon199443137 · DOI
  78. Kobayashi A, 2000, Aviat Space Environ Med, 71, 177
  79. 10.1055/s-2001-17369 · DOI
  80. 10.1034/j.1399-6576.1999.430503.x · DOI
  81. 10.1152/ajpheart.1978.234.4.H371 · DOI
  82. 10.1161/01.CIR.0000030939.12646.8F · DOI · Paper page
  83. 10.1161/hc6172.099397 · DOI · Paper page
  84. 10.1152/jappl.1961.16.3.473 · DOI
  85. 10.1161/01.STR.25.10.1985 · DOI
  86. 10.1152/physrev.1959.39.2.183 · DOI
  87. Lassen NA., 1964, Circ Res, 15, 201
  88. 10.1016/S0002-9149(00)01002-X · DOI
  89. 10.1177/014107689608900705 · DOI
  90. 10.1002/ana.410360217 · DOI · Paper page
  91. 10.1212/WNL.46.4.1086 · DOI
  92. 10.1172/JCI100470 · DOI
  93. 10.1161/01.CIR.90.1.298 · DOI · Paper page
  94. 10.1161/01.STR.31.8.1897 · DOI
  95. 10.1152/ajpheart.1998.274.5.H1729 · DOI
  96. 10.1152/jappl.1968.24.5.625 · DOI
  97. 10.1016/S0002-9629(15)40486-0 · DOI
  98. 10.1152/jappl.1994.77.5.2155 · DOI
  99. 10.1152/jappl.1998.85.2.667 · DOI
  100. 10.1161/01.STR.10.6.711 · DOI
  101. 10.1111/j.1475-097X.1995.tb00541.x · DOI
  102. 10.1046/j.1365-201X.1998.0308f.x · DOI
  103. Madsen P, 1998, Aviat Space Environ Med, 69, 781
  104. 10.1016/S0301-0082(98)00093-8 · DOI
  105. 10.3171/jns.1975.43.5.0523 · DOI
  106. 10.1212/WNL.45.3.498 · DOI
  107. 10.1161/01.STR.31.7.1615 · DOI
  108. 10.1213/00000539-198709000-00003 · DOI
  109. 10.1152/ajpheart.1997.272.3.H1419 · DOI
  110. 10.1161/01.STR.25.4.793 · DOI
  111. 10.1161/01.STR.23.12.1743 · DOI
  112. 10.1161/01.STR.29.9.1876 · DOI · Paper page
  113. 10.1097/00008506-199610000-00004 · DOI
  114. 10.1152/ajpregu.00285.2001 · DOI
  115. 10.1097/00000441-199105000-00002 · DOI
  116. 10.1088/0967-3334/19/3/001 · DOI
  117. 10.1152/ajpheart.1999.277.3.H1089 · DOI
  118. 10.1088/0967-3334/20/3/304 · DOI
  119. 10.1007/BF02522477 · DOI
  120. Paulson OB, 1990, Cerebrovasc Brain Metab Rev, 2, 161
  121. 10.1152/jappl.1992.73.5.1838 · DOI
  122. 10.1111/j.1748-1716.1993.tb09541.x · DOI
  123. Piorry PA., 1826, Arch Gén Médecine, 12, 527
  124. 10.1152/jappl.2000.88.5.1545 · DOI
  125. 10.1152/jappl.1996.81.3.1084 · DOI
  126. Remmen JJ, 2002, Clin Sci (Lond), 103, 143, 10.1042/cs1030143 · DOI
  127. 10.1007/s007010050422 · DOI
  128. Richardson DW, 1972, Am J Physiol, 223, 1308, 10.1152/ajplegacy.1972.223.6.1308 · DOI
  129. 10.1007/BF03030998 · DOI
  130. 10.3171/jns.1986.65.5.0636 · DOI
  131. 10.1152/ajpregu.1988.255.1.R149 · DOI
  132. 10.1152/ajpregu.1986.251.4.R742 · DOI
  133. 10.1152/ajpheart.2001.281.2.H774 · DOI
  134. 10.1016/S0197-0186(99)00067-4 · DOI
  135. 10.1172/JCI102150 · DOI
  136. 10.1007/BF00417998 · DOI
  137. 10.1111/j.1749-6632.2001.tb03702.x · DOI
  138. 10.1161/01.STR.28.8.1564 · DOI
  139. 10.1152/jappl.2001.91.6.2493 · DOI
  140. 10.1161/01.STR.31.7.1672 · DOI
  141. 10.1172/JCI106455 · DOI
  142. 10.1136/bmj.2.4841.860 · DOI
  143. 10.1136/bmj.1.4965.506 · DOI
  144. 10.1111/j.1469-7793.1999.0001o.x · DOI · Paper page
  145. 10.1249/00005768-198710000-00003 · DOI
  146. 10.1152/jappl.1991.70.2.523 · DOI
  147. Sutton R., 1992, Eur J Card Pacing Electrophysiol, 2, 89
  148. Sutton R., 1999, Eur Heart J, Suppl, 1, D109
  149. 10.1007/BF01818996 · DOI
  150. 10.1042/cs0870553 · DOI · Paper page
  151. 10.1016/0022-510X(80)90127-6 · DOI
  152. 10.1161/01.STR.26.6.1014 · DOI
  153. 10.1161/01.STR.26.8.1386 · DOI
  154. 10.1113/jphysiol.1993.sp019958 · DOI
  155. 10.1152/jappl.2000.88.2.655 · DOI
  156. 10.1016/0165-1838(94)00105-S · DOI
  157. 10.1152/jappl.1997.82.4.1256 · DOI
  158. 10.1152/ajpheart.1998.274.5.H1715 · DOI
  159. 10.1007/978-1-4684-8181-5_11 · DOI
  160. 10.1161/01.STR.32.7.1546 · DOI
  161. 10.1016/0140-6736(92)90932-S · DOI · Paper page
  162. 10.1111/j.1540-8159.1997.tb03901.x · DOI · Paper page
  163. 10.1042/cs0810575 · DOI · Paper page
  164. 10.1152/japplphysiol.00616.2001 · DOI
  165. 10.1159/000099687 · DOI
  166. 10.1016/0002-8703(59)90190-5 · DOI
  167. 10.1152/jappl.1993.74.5.2566 · DOI
  168. 10.1097/00008506-200007000-00002 · DOI
  169. 10.1097/00000542-199412000-00015 · DOI
  170. Whinnery JE, 1993, Aviat Space Environ Med, 64, 952
  171. 10.1113/jphysiol.1996.sp021518 · DOI
  172. 10.1007/s10286-002-0019-9 · DOI
  173. 10.1042/cs0940347 · DOI
  174. 10.1002/bjs.1800810911 · DOI
  175. Yilmaz U, 1999, Aviat Space Environ Med, 70, 709
  176. 10.1152/ajpheart.1998.274.1.H233 · DOI
  177. 10.1152/jappl.1998.85.3.1113 · DOI · Paper page

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Metadata

Authors
Van Lieshout, J. J., Wieling, W., Karemaker, J. M., & Secher, N. H.
Affiliations
  • Cardiovascular Research Institute Amsterdam and Departments of
  • Amsterdam UMC Location University of Amsterdam (NL)
  • University of Copenhagen (DK)
ORCID
Venue
Journal of Applied Physiology
Publisher
American Physiological Society
Published
2003-03-01
Volume
94
Issue
3
Pages
833-848
ISSN
  • 0161-7567 (ISSN-L)
  • 8750-7587
  • 1522-1601
DOI
10.1152/japplphysiol.00260.2002
OpenAlex
W2114919659
Cited by
365
References
6
Citations by year
2026: 9 · 2025: 6 · 2024: 10 · 2023: 11 · 2022: 9 · 2021: 13 · 2020: 16 · 2019: 13 · 2018: 11 · 2017: 24 · 2016: 17 · 2015: 12 · 2014: 25 · 2013: 14 · 2012: 18
FWCI
2.58
Type
journal article
Language
en
Open access
closed
Locations
  • Journal of Applied Physiology (publishedVersion)
  • PubMed (publishedVersion)
  • Data Archiving and Networked Services (DANS) (submittedVersion)
  • Pure Amsterdam UMC (submittedVersion)
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 › Physiology (medical) › Cardiovascular and exercise physiology
Keywords
syncope, cerebral autoregulation, cerebral blood flow, cerebral oxygenation, vasovagal syncope, postural stress, standing, muscle pump, cerebral blood flow velocity, near-infrared spectroscopy, transcranial Doppler, cerebrovascular resistance, cardiac output redistribution, lightheadedness, autonomic failure
MeSH terms
Cerebrovascular Circulation, Gravitation, Hemodynamics, Humans, Hypotension, Orthostatic, Oxygen, Oxygen Consumption, Syncope

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