СПОРНЫЕ ВОПРОСЫ ПАТОГЕНЕЗА НЕЙРОМЕДИАТОРНЫХ СИНКОПОВ
Аннотация
Рассматриваются вопросы патофизиологии синкопальных состояний, анализируются современные теории, объясняющие их возникновение снижением заполнения левого желудочка, особенностями действия нейротрансмиттеров, барорефлекторной дисфункцией и иными причинами.
Ключевые слова
нейромедиаторные синкопы,
преходящие потери сознания,
барорефлекс,
гипотензия,
брадикардия,
тилт-тест,
серотонин
Об авторах
Д. В. Дупляков
Самарский областной клинический кардиологический диспансер, МСЧ ОАО «АВТОВАЗ», Тольятти
Россия
Россия
Г. А. Головина
Самарский областной клинический кардиологический диспансер, МСЧ ОАО «АВТОВАЗ», Тольятти
Россия
Россия
Е. А. Гаврилова
Самарский областной клинический кардиологический диспансер, МСЧ ОАО «АВТОВАЗ», Тольятти
Россия
Россия
Список литературы
1. Brignole M., Alboni P., Benditt D.G. et al. Guidelines on management (diagnosis and treatment) of syncope-Update 2004. Europace 2004;6,467-537.
2. Soteriades E.S., Evans J.C., Larson M.G. et al. Incidence and prognosis of syncope. N Engl J Мed 2002;347:878-885.
3. Sorajja D., Conti R. Sincope while driving: clinical characteristics, etiologies, and prognosis. Cardiosource. 2006; available at www.cardiosource.com.
4. Alboni P., Brignole M., degli Uberti E.C. Is vasovagal a disease? Europace 2007;9:83-87.
5. Mosgueda-Garcia R., Furlan R., Tank J., Fernandez-Violante R. The elusieve pathophysiology of neurally mediated syncope. Circulation 2000;5:2898-2906.
6. Grubb B.P. Pathophysiology and differential diagnosis of neurocardiogenic syncope. Am. J. Cardiol. 1999;84:3Q- 9Q.
7. Hainsworth R. Syncope: what is the trigger? Heart 2003;89:123-124.
8. Oberg B., Thoren P. Increased activity in left ventricular receptors during hemorrhage or occlusion of caval veins in the cat: a possible cause of the vaso-vagal reaction. Acta Physiol Scand 1972;85:164-173.
9. Kosinski D., Grubb B.P., Temesy-Armos P. Pathophysiological aspects of neurocardiogenic syncope: current concepts and new perspective. PACE 1995;18:716-724.
10. Sheldon R. Role of pacing in the treatment of vasovagal syncope. Am. J. Cardiol. 1999;84:26Q-32Q.
11. Гуков А.О., Жданов А.М. Синдром каротидного синуса и вазовагальные синкопе. Терапевтический ар-хив;2000,12:72-75.
12. Mosqueda-Garcia R., Furlan R., Fernandez-Violante R. et al. Sympathetic and baroreceptor reflex function in neurally mediated syncope evoked by tilt. J. Clin. Invest. 1997;99:2736 -2744.
13. Novak V., Honos G., Schondorf R. Is the heart empty at syncope? J Auton Nerv Syst. 1996;60:83-92.
14. Lee T.M., Chen M.F., Su S.F. et al. Excessive myocardial contraction in vasovagal syncope demonstrated by echocardiography during head-up tilt. Clin. Cardiol. 1996;19:137-140.
15. Scherrer U., Vissing S., Morgan B.J. et al. Vasovagal syncope after infusion of a vasodilator in a heart-transplant patient. N Engl J Med. 1990;322:602-604.
16. Grubb B.P., Gerard G., Roush K. et al. Cerebral vasoconstriction during head-upright tilt-induced vasovagal syncope. Circulation. 1991;84:1157-1164.
17. Fitzpatrick A.P., Williams T., Ahmed R. et al. Echocardiographic and endocrine changes during vasovagal syncope induced by prolonged head-up tilt. Eur. JCPE. 1992;2:121-128.
18. Sra J.S., Murthy V., Natale A. et al. Circulatory and catecholamine changes during head-up tilt testing in neurocardiogenic (vasovagal) syncope. Am. J. Cardiol. 1994;73:33-37.
19. Goldstein D.S., Spanarkel M., Pitterman A. et al. Circulatory control mechanisms in vasodepressor syncope. Am. Heart J. 1982;104:1071-1075.
20. Jacobs M.C., Goldstein D.S., Willemsen J.J. et al. Neurohumoral antecedents of vasodepressor reactions. Eur. J. Clin. Invest. 1995;25:754 -761.
21. Тюрина Т.В., Меркулова Н.К., Иванова Т.И. Нейрогуморальная регуляция при нейрогенных обмороках, спровоцированных при тилт-тесте. Вестник аритмологии 2005;39:35-42.
22. Morillo C.A., Eckberg D.L., Ellenbogen K.A. et al. Vagal and sympathetic mechanisms in patients with orthostatic vasovagal syncope. Circulation. 1997;96:2509 -2513.
23. Furlan R., Piazza S., DellOrto S. et al. Cardiac autonomic patterns preceding occasional vasovagal reactions in healthy humans. Circulation. 1998;98:1756 -1761.
24. Lipsitz L.A., Mietus J., Moody G.B. et al. Spectral characteristics of heart rate variability before and during postural tilt: relations to aging and risk of syncope. Circulation. 1990;81:1803-1810.
25. Тюрина Т.В. Вариабельность сердечного ритма у больных с кардиоингибиторными и вазодепрессорными нейрогенными обмороками. Вестник аритмологии 2004;35:приложение С, 70-72.
26. Virag N., Sutton R., Vetter R., Markowitz T., Erickson M. Prediction of vasovagal syncope from heart rate and blood pressure trend and variability: experience in 1.155 patients. Heart Rhythm 2007;11:1375-1382.
27. Morillo C.A., Leitch J.W., Yee R., Klein G.J. A placebo-controlled trial of intravenous and oral disopyramide for prevention of neurally mediated syncope induced by head-up tilt. J. Am. Coll. Cardiol. 1993;22:1843-1848.
28. Raviele A., Brignole M., Sutton R. et al. Effect of etilefrine in preventing syncopal recurrence in patients with vasovagal syncope: a double blind, randomized, placebocontrolled trial. The Vasovagal Syncope International Study. Circulation 1999;99:1452-1457.
29. Мadrid A., Ortega I., Robollo G.J. et al. Lack of efficacy of atenolol for the prevention of neurally-mediated syncope in highly symptomatic population: a prospective double-blind, randomized and placebo-controlled study. J. Am. Coll. Cardiol. 2001;37:554-557.
30. Ward C.R., Gray J.C., Gilroy J.J. et al. Midodrine a role in the management of neurocardiogenic syncope. Heart 1998;79:45-49.
31. Perez-Lugones A., Schweikert R., Pavia S. et al. Usefulness of midodrine in patients with severely symptomatic neurocardiogenic syncope: a randomized control study. J Cardiovasc. Electrophysiol. 2001;12:935-938.
32. Fitzpatrick A.P., Ahmed R., Williams S., Sutton R. A randomized trial of medical therapy in «malignant vasovagal syndrome» or «neurally-mediated bradycardia/hypotension syndrome». Eur. J. Cardiac. Pacing Electrophysiol 1991;1:99-102.
33. Lee T.M., Su S.F., Chen M.F. et al. Usefullness of transdermal scopolamine for vasovagal syncope. Am. J. Cardiol. 1996;78:480-482.
34. Dietz N.M., Joyner M.J., Shepherd J.T. Vasovagal syncope and skeletal muscle vasodilatation: the continuing conundrum. PACE 1997;20:775-780.
35. Brignole M., Sutton R., Menozzi C. et al. Early application of an Implantable Loop Recorder allows a mechanism-based effective therapy in patients with recurrent suspected neurally-mediated syncope. Eur. Heart J. 2006;27:1085-1092.
36. Perna G.P., Ficola U., Salvatori M.P. et al. Increase of plasma в-endorphins in vasodepressor syncope. Am. J. Cardiol. 1990;65:929-930.
37. Smith M.L., Carlson M.D., Thames M.D. Naloxone does not prevent vasovagal syncope during orthostasis in humans. J. Auton. Nerv. Syst. 1993;34:1-9.
38. Riegger G.A., Wagner A. Excessive secretion of vasopressin during vasovagal reaction. Am. Heart J. 1991; 121: 602-603.
39. Abboud F.M. Neurocardiogenic syncope. N. Engl. J. Med. 1993;328:1117-1120.
40. Samoil D.A., Grubb B.P. Nеurallу-mediated syncope and serotonin reuptake inhibitors. Clin. Auton. Res. 1995;5:251-255.
41. Grubb B.P., Wolfe D.A., Samoil D. et al. Usefulness of fluoxetine hydrochloride for prevention upright tilt induced syncope. PACE 1993;16:458-464.
42. Grubb B.P., Samoil D., Kosinski D. et al. Use of sertraline hydrochloride in the treatment of refractory neuro-cardiogenic syncope in children and adolescents. J. Am. Coll. Cardiol. 1994;24:490-494.
43. Di Girolamo E., Di Iorio C., Sabatini P. et al. Effects of parpxetine hydrochloride, a selective serotonin reuptake, on refractory vasovagal syncope; a randomized, doubleblind, placebo-controlled stady. J. Am. Coll. Cardiol. 1999;33:1227-1230.
44. Takata T.S., Wasmund S.L., Smith M.L. et al. Serotonin reuptake inhibitor (Paxil) does not prevent the vasovagal reaction associated with carotid sinus massage and/ or lower body negative pressure in healthy volunteers. Circulation 2002;106:1500-1504.
45. Thomson H.L., Wright K., Frenneaux M. Baroreflex sensitivity in patients with vasovagal syncope. Circulation 1997;95:395- 400.
46. Victor R.G., Thoren P., Morgan D.A. et al. Differential control of adrenal and renal sympathetic nerve activity during hemorrhagic hypotension in rats. Circ. Res. 1989;64:686-694.
47. Eckberg D.L., Harkins S.W., Fritsch J.M. et al. Barore-flex control of plasma norepinephrine and heart period in healthy subjects and diabetic patients. J. Clin. Inv. 1986; 78:366 -374.
48. van Lieshout J.J., Wieling W., Karemaker J.M. et al. The vasovagal response. Clin Sci. 1991;81:575-586.
49. Mercader M.A., Varghese PJ., Potolicchio S.J. et al. New insights into the mechanism of neurally mediated syncope. Heart 2002;88:217-221.
50. Duplyakov D., Gavrilova E., Golovina G., Lyukshina N., Sysuenkova E., Shagrova E., Bulanova V. Prevalence of epileptiform findings on routine EEG and its influence on the result of head-up tilt test in patients with neurocar-diogenic syncope European Heart Journal 2007;28 ( Abstract Supplement ), 640
51. Дупляков Д. В., Головина Г. А., Гаврилова Е.А. и др. Эпилептиформная активность в ходе тилт-теста у пациентов с нейрокардиогенными обмороками. Вопросы аритмологии 2008, прил.А. C.75-76.
52. Bergfeldt L. Differential diagnosis of cardiogenic syncope and seizure disorders. Heart 2003;89:353-358.
53. Альбицкая К.В., Кучинская Е.А., Хеймец Г.И. и др. Cостояние симпатической иннервации миокарда по данным сцинтиграфии с 123!-метайодбензилгуанедином у пациентов с вазовагальными обмороками. Вестник аритмологии 2007;50:11-16.
54. Brignole M., Menozzi C., Del Rosso A. et al. New classification of haemodynamics of vasovagal syncope: beyond the VASIS Classification. Analysis of the presyncopal phase of the tilt test without and with nitroglycerin challenge. Europace 2000;2:66-76.
55. Brignole M., Sutton R., Menozzi C. et al. Lack of correlation between the responses to Tilt Testing and Adenosine Triphosphate Test and the mechanism of spontaneous neurally-mediated syncope. Eur. Heart J. 2006;27:2232-2239.
56. Sutton R., Brignole M., Menozzi C. et al. Dual-chamber pacing in treatment of neurally-mediated tilt-positive cardioinhibitory syncope. Pacemaker versus no therapy: a multicentre randomized study. Circulation 2000;102:294-299.
57. Ammirati F., Colivicchi F., Santini M. Permanent Cardiac Pacing versus medical treatment for the prevention of recurrent vasovagal syncope. A multicenter, randomized, controlled trial. Circulation 2001;104:52-57.
Рецензия
Для цитирования:
Дупляков Д.В., Головина Г.А., Гаврилова Е.А. СПОРНЫЕ ВОПРОСЫ ПАТОГЕНЕЗА НЕЙРОМЕДИАТОРНЫХ СИНКОПОВ. Вестник аритмологии. 2008;51(51):44-49.
For citation:
Duplyakov D.V., Golovina G.A., Gavrilova E.A. CONTROVERSIAL ASPECTS OF PATHOGENY OF NEUROMEDIATOR SYNCOPE. Journal of Arrhythmology. 2008;51(51):44-49. (In Russ.)
Просмотров:
198
Послать статью по эл. почте 