Beat-to-beat analysis of pressure wave morphology for pre-symptomatic detection of orthostatic intolerance during head-up tilt

Salvatore M. Romano, Chiara Lazzeri, Marco Chiostri, Gian Franco Gensini, Franco Franchi

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

The aim of this study was to noninvasively define the hemodynamic profile characterizing the early response to tilting. The mechanisms causing orthostatic intolerance have not been fully elucidated. Usually, patients undergoing tilt test are studied in a time-consuming way. Moreover, the test can cause discomfort to the patient and even be potentially hazardous. Nineteen orthostatic intolerant patients (OIP), compared with 22 healthy subjects (HS), performed head-up tilt test while their arterial pressure waveform was noninvasively recorded. We elaborated data using the Pressure Recording Analytical Method to obtain hemodynamic parameters, then analyzing the variables by discriminant analysis. Compared with HS, OIP showed lower stroke volume index (SVI) values even in baseline conditions associated with higher values of systemic vascular resistance (SVR) and heart rate (HR). From the third minute of the tilted position and until symptoms appeared, patients exhibited lower values of blood pressure (BP) and SVI and higher HR values but no difference in SVR. At termination, patients showed a further significant reduction in BP and SVI and a persistent increase in HR. This investigation underlines: 1) the possibility of beat-to-beat monitoring of hemodynamic changes during tilting; 2) the cardiovascular profile of OIP at rest, characterized by lower SVI and higher SVR and HR; 3) the maladaptive response to postural challenge of OIP mainly identifiable in impaired vascular regulation; and 4) the possibility of detecting parameters that enable prompt identification of the positive response to tiltingin these patients, thus guiding the duration of the test.

Original languageEnglish
Pages (from-to)1891-1897
Number of pages7
JournalJournal of the American College of Cardiology
Volume44
Issue number9
DOIs
Publication statusPublished - Nov 2 2004

Fingerprint

Orthostatic Intolerance
Head
Pressure
Stroke Volume
Heart Rate
Vascular Resistance
Hemodynamics
Blood Volume
Healthy Volunteers
Blood Pressure
Discriminant Analysis
Blood Vessels
Arterial Pressure

ASJC Scopus subject areas

  • Nursing(all)

Cite this

Beat-to-beat analysis of pressure wave morphology for pre-symptomatic detection of orthostatic intolerance during head-up tilt. / Romano, Salvatore M.; Lazzeri, Chiara; Chiostri, Marco; Gensini, Gian Franco; Franchi, Franco.

In: Journal of the American College of Cardiology, Vol. 44, No. 9, 02.11.2004, p. 1891-1897.

Research output: Contribution to journalArticle

Romano, Salvatore M. ; Lazzeri, Chiara ; Chiostri, Marco ; Gensini, Gian Franco ; Franchi, Franco. / Beat-to-beat analysis of pressure wave morphology for pre-symptomatic detection of orthostatic intolerance during head-up tilt. In: Journal of the American College of Cardiology. 2004 ; Vol. 44, No. 9. pp. 1891-1897.
@article{6cb0bba69b444af3ae0d3ec9bc683e76,
title = "Beat-to-beat analysis of pressure wave morphology for pre-symptomatic detection of orthostatic intolerance during head-up tilt",
abstract = "The aim of this study was to noninvasively define the hemodynamic profile characterizing the early response to tilting. The mechanisms causing orthostatic intolerance have not been fully elucidated. Usually, patients undergoing tilt test are studied in a time-consuming way. Moreover, the test can cause discomfort to the patient and even be potentially hazardous. Nineteen orthostatic intolerant patients (OIP), compared with 22 healthy subjects (HS), performed head-up tilt test while their arterial pressure waveform was noninvasively recorded. We elaborated data using the Pressure Recording Analytical Method to obtain hemodynamic parameters, then analyzing the variables by discriminant analysis. Compared with HS, OIP showed lower stroke volume index (SVI) values even in baseline conditions associated with higher values of systemic vascular resistance (SVR) and heart rate (HR). From the third minute of the tilted position and until symptoms appeared, patients exhibited lower values of blood pressure (BP) and SVI and higher HR values but no difference in SVR. At termination, patients showed a further significant reduction in BP and SVI and a persistent increase in HR. This investigation underlines: 1) the possibility of beat-to-beat monitoring of hemodynamic changes during tilting; 2) the cardiovascular profile of OIP at rest, characterized by lower SVI and higher SVR and HR; 3) the maladaptive response to postural challenge of OIP mainly identifiable in impaired vascular regulation; and 4) the possibility of detecting parameters that enable prompt identification of the positive response to tiltingin these patients, thus guiding the duration of the test.",
author = "Romano, {Salvatore M.} and Chiara Lazzeri and Marco Chiostri and Gensini, {Gian Franco} and Franco Franchi",
year = "2004",
month = "11",
day = "2",
doi = "10.1016/j.jacc.2004.07.046",
language = "English",
volume = "44",
pages = "1891--1897",
journal = "Journal of the American College of Cardiology",
issn = "0735-1097",
publisher = "Elsevier USA",
number = "9",

}

TY - JOUR

T1 - Beat-to-beat analysis of pressure wave morphology for pre-symptomatic detection of orthostatic intolerance during head-up tilt

AU - Romano, Salvatore M.

AU - Lazzeri, Chiara

AU - Chiostri, Marco

AU - Gensini, Gian Franco

AU - Franchi, Franco

PY - 2004/11/2

Y1 - 2004/11/2

N2 - The aim of this study was to noninvasively define the hemodynamic profile characterizing the early response to tilting. The mechanisms causing orthostatic intolerance have not been fully elucidated. Usually, patients undergoing tilt test are studied in a time-consuming way. Moreover, the test can cause discomfort to the patient and even be potentially hazardous. Nineteen orthostatic intolerant patients (OIP), compared with 22 healthy subjects (HS), performed head-up tilt test while their arterial pressure waveform was noninvasively recorded. We elaborated data using the Pressure Recording Analytical Method to obtain hemodynamic parameters, then analyzing the variables by discriminant analysis. Compared with HS, OIP showed lower stroke volume index (SVI) values even in baseline conditions associated with higher values of systemic vascular resistance (SVR) and heart rate (HR). From the third minute of the tilted position and until symptoms appeared, patients exhibited lower values of blood pressure (BP) and SVI and higher HR values but no difference in SVR. At termination, patients showed a further significant reduction in BP and SVI and a persistent increase in HR. This investigation underlines: 1) the possibility of beat-to-beat monitoring of hemodynamic changes during tilting; 2) the cardiovascular profile of OIP at rest, characterized by lower SVI and higher SVR and HR; 3) the maladaptive response to postural challenge of OIP mainly identifiable in impaired vascular regulation; and 4) the possibility of detecting parameters that enable prompt identification of the positive response to tiltingin these patients, thus guiding the duration of the test.

AB - The aim of this study was to noninvasively define the hemodynamic profile characterizing the early response to tilting. The mechanisms causing orthostatic intolerance have not been fully elucidated. Usually, patients undergoing tilt test are studied in a time-consuming way. Moreover, the test can cause discomfort to the patient and even be potentially hazardous. Nineteen orthostatic intolerant patients (OIP), compared with 22 healthy subjects (HS), performed head-up tilt test while their arterial pressure waveform was noninvasively recorded. We elaborated data using the Pressure Recording Analytical Method to obtain hemodynamic parameters, then analyzing the variables by discriminant analysis. Compared with HS, OIP showed lower stroke volume index (SVI) values even in baseline conditions associated with higher values of systemic vascular resistance (SVR) and heart rate (HR). From the third minute of the tilted position and until symptoms appeared, patients exhibited lower values of blood pressure (BP) and SVI and higher HR values but no difference in SVR. At termination, patients showed a further significant reduction in BP and SVI and a persistent increase in HR. This investigation underlines: 1) the possibility of beat-to-beat monitoring of hemodynamic changes during tilting; 2) the cardiovascular profile of OIP at rest, characterized by lower SVI and higher SVR and HR; 3) the maladaptive response to postural challenge of OIP mainly identifiable in impaired vascular regulation; and 4) the possibility of detecting parameters that enable prompt identification of the positive response to tiltingin these patients, thus guiding the duration of the test.

UR - http://www.scopus.com/inward/record.url?scp=7044286049&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=7044286049&partnerID=8YFLogxK

U2 - 10.1016/j.jacc.2004.07.046

DO - 10.1016/j.jacc.2004.07.046

M3 - Article

C2 - 15519025

AN - SCOPUS:7044286049

VL - 44

SP - 1891

EP - 1897

JO - Journal of the American College of Cardiology

JF - Journal of the American College of Cardiology

SN - 0735-1097

IS - 9

ER -