Abstract
Orthostatic stimuli are known to elicit changes in vasoactive peptide levels. The hypothesis of no difference in adrenomedullin and/or galanin levels in patients with recurrent vasovagal syncope and healthy controls was tested in a passive 35-min head-up tilt test (HUTT). Twenty eight persons (14 patients and 14 healthy controls) were tested in a 35-min/60° head-up tilt test with telemetry monitoring. Three blood samples were evaluated for each person during the HUTT. Plasma levels of adrenomedullin and galanin were analysed by the Kruskal-Wallis test for all sampling periods. Vagal influence was indirectly assessed by the break index. There were no significant differences between groups in median values for either adrenomedullin or galanin plasma levels (all 6 p-values were greater than 0.4). For adrenomedullin, no significant difference between groups was found. For galanin, the rate of change between the 1st and 2nd measurement was significantly greater for patients (P=0.04), regardless of HUTT result but between the 2(nd) and 3(rd) measurement it was insignificant (P=0.36). In the group of positive cases, the break index increased significantly (P=0.02). We confirmed that there is a different galanin secretion pattern during orthostatic provocation in patients with recurrent vasovagal syncope than healthy individuals. For adrenomedullin, no significant difference was found. Asignificant increment of the break index confirmed increased vagal influence in the subgroup of positive cases.
Highlights
According to the European Society of Cardiology Guidelines[1] syncope is a symptom defined as a transient, self-limited loss of consciousness and postural tone
We investigated whether the secretion patterns of GAL and ADM during head-up tilt test (HUTT) differ in patients suffering from recurrent vasovagal syncope and for healthy individuals
Our results show that there is no strong adherence of galanin secretion pattern to orthostatic stimuli, the galaninergic system is involved in the vasovagal response
Summary
According to the European Society of Cardiology Guidelines[1] syncope is a symptom defined as a transient, self-limited loss of consciousness and postural tone. Like GAL, ADM has a very conserved amino acid sequence which places ADM in the evolutionary line at the pre-dinosaur age[11] For this reason, ADM has been studied in many disease states including hypertension, heart and renal failure. We investigated whether the secretion patterns of GAL and ADM during HUTT differ in patients suffering from recurrent vasovagal syncope (rVVS) and for healthy individuals. We concentrated both on the total level of blood plasma GAL and ADM (absolute values) and on their rates of change (relative values). We employed the brake index as an indirect measure of vagal influence
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