Autonomic modulation and cardiac contractility in vasovagal syncope

Antonio Franco Folino, Giulia Russo, Alberto Porta, Gianfranco Buja, Sergio Cerutti, Sabino Iliceto

Research output: Contribution to journalArticlepeer-review


Background: Previous studies proposed as one of the main mechanisms involved in neurally mediated syncope, the stimulation of ventricular mechanoreceptors as the final trigger for vagal discharge. Objectives: This study aimed to verify the presence of a sympathetic driven increase of cardiac contractility before vasovagal syncope. Methods: We studied 23 patients with recurrent syncope. All underwent a 60° tilt with pharmacologic challenge (sublingual spray nitrate). Two conditions were used to assess autonomic activity by heart rate variability analysis: in a supine position after 5 min of rest and after 15 min of tilt. Simultaneously, cardiac contractility was quantified by tissue-Doppler echocardiography at the base of the free walls of left ventricle. The peak myocardial velocities during systole (Sw) and late diastole (Aw) were considered. Results: Passive tilt induced a significant increase of the low frequency component (LF) as well as a decrease of the high frequency component (HF) in positive patients (LF: from 49±18 to 65±18 nu, p

Original languageEnglish
Pages (from-to)248-253
Number of pages6
JournalInternational Journal of Cardiology
Issue number3
Publication statusPublished - Mar 18 2010


  • Autonomic activity
  • Heart rate variability
  • Syncope
  • Tilt test
  • Tissue Doppler echocardiography

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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