Abstract
Supine-to-standing test(SST), a transcranial Doppler (TCD) based technique, has been recently developed to evaluate cardiovascular dysautonomia. In patients with multiple system atrophy(MSA), a natural human model of baroreflex failure, STS detects blunted cerebral blood flow velocity rebound after standing and/or sustained higher pulsatility index upon standing than supine baseline. This finding can be used to predict the adverse outcomes of neurogenic syncope. It is known cerebral blood flow changes in response to orthostatic challenges in the initial (first 30 s) and early phases (1e2 min upright) after standing are mainly governed by the neural system. This technique of STS can be easily applied in daily out-clinics practice for the evaluation of early neurogenic orthostatic hypotension after active standing.
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