OBJECTIVE: to quantify autonomic function in bedfast elderly patients. PATIENTS AND METHODS: we analysed orthostatic blood pressure, heart rate response to tilt, heart rate response to deep breathing, quantitative sudomotor axon reflex test (QSART) and beat-to-beat blood pressure during phases II and IV of the Valsalva manoeuvre (VM) in 15 patients with (OH+) and without orthostatic hypotension (OH-) and 12 age-matched controls. RESULTS: all bedfast patients had a poor response in the late phase II of beat-to-beat blood pressure, while OH+ patients had an additional abnormality in phase IV. QSARTs in the distal leg and foot were decreased in both OH+ and OH- groups. There was no difference between the two groups in duration of being bedfast or in activities of daily living. CONCLUSIONS: (i) being bedfast results in postganglionic sympathetic dysfunction in the lower extremities; (ii) some patients who have beta-adrenergic dysfunction have OH and (iii) preventing patients from becoming being bedfast may be important for the maintenance of normal autonomic functions.
OBJECTIVE: to quantify autonomic function in bedfast elderly patients. PATIENTS AND METHODS: we analysed orthostatic blood pressure, heart rate response to tilt, heart rate response to deep breathing, quantitative sudomotor axon reflex test (QSART) and beat-to-beat blood pressure during phases II and IV of the Valsalva manoeuvre (VM) in 15 patients with (OH+) and without orthostatic hypotension (OH-) and 12 age-matched controls. RESULTS: all bedfast patients had a poor response in the late phase II of beat-to-beat blood pressure, while OH+ patients had an additional abnormality in phase IV. QSARTs in the distal leg and foot were decreased in both OH+ and OH- groups. There was no difference between the two groups in duration of being bedfast or in activities of daily living. CONCLUSIONS: (i) being bedfast results in postganglionic sympathetic dysfunction in the lower extremities; (ii) some patients who have beta-adrenergic dysfunction have OH and (iii) preventing patients from becoming being bedfast may be important for the maintenance of normal autonomic functions.
Authors: Bonnie E Legg Ditterline; Sevda C Aslan; David C Randall; Susan J Harkema; Alexander V Ovechkin Journal: Respir Physiol Neurobiol Date: 2016-04-30 Impact factor: 1.931