Autonomic dysfunction in systemic sclerosis: Sympathetic overactivity and instability
purpose: This study was designed to assess the prevalence and nature of autonomic dysfunction (AD) in 34 patients with systemic sclerosis (SSc). patients and methods: Patients were questioned for current symptoms possibly related to AD. Five noninvasive cardiovascular autonomic function tests and se...
Gespeichert in:
| Veröffentlicht in: | The American journal of medicine 1992-08, Vol.93 (2), p.143-150 |
|---|---|
| Hauptverfasser: | , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 150 |
|---|---|
| container_issue | 2 |
| container_start_page | 143 |
| container_title | The American journal of medicine |
| container_volume | 93 |
| creator | Dessein, Patrick H. Joffe, Barry I. Metz, Reeva M. Millar, Denise L. Lawson, Mary Stanwix, Anne E. |
| description | purpose: This study was designed to assess the prevalence and nature of autonomic dysfunction (AD) in 34 patients with systemic sclerosis (SSc).
patients and methods: Patients were questioned for current symptoms possibly related to AD. Five noninvasive cardiovascular autonomic function tests and sequential plasma catecholamine estimations at rest, during standing, and during sustained handgrip were performed. Seven patients with manometrically documented esophageal involvement and high resting plasma adrenaline levels were treated with clonidine (75 to 375 μg/d). One month later, resting plasma catecholamine estimations and esophageal motility studies were repeated.
results: Autonomic testing revealed AD in each patient, while symptoms were experienced by 33 of them. Findings on two of the three heart rate tests and both blood pressure tests were significantly impaired as compared with those in 25 matched control subjects. Mean resting plasma adrenaline levels were 18 times higher than in 10 matched controls (p |
| doi_str_mv | 10.1016/0002-9343(92)90043-B |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_73107977</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>000293439290043B</els_id><sourcerecordid>5758692</sourcerecordid><originalsourceid>FETCH-LOGICAL-c479t-8e2206723e8e46292896f25bd0b970e8a481b8195f35918865876d519997c50f3</originalsourceid><addsrcrecordid>eNp9kUuLFTEQhYMo453Rf6DQiAy6aM2j83IhzAy-YMCFzjqk09WYoTu5JukL_e9Ncy8juHBVVNV3ipMThF4Q_I5gIt5jjGmrWcfeaPpWY9yx9voR2hHOeSuJoI_R7gF5is5zvq8t1lycoTPSaYkJ3qG7q6XEEGfvmmHN4xJc8TE0PjR5zQW2eXYTpJh9_tD8WOe9Lb-g1HE8QLKVPviyNjYMVZOL7f1U-2foyWinDM9P9QLdff708-Zre_v9y7ebq9vWdVKXVgGlWEjKQEEnqKZKi5HyfsB9tQfKdor0img-Mq6JUoIrKQZOtNbScTyyC3R5vLtP8fcCuZjZZwfTZAPEJRvJCJZaygq--ge8j0sK1ZuhjDJCMCMV6o6Qq8_NCUazT362aTUEmy1ys-VptjyNrnWL3FxX2cvT7aWfYfgrOmZc969Pe5udncZkg_P5AavfJYTYsI9HDGpgBw_JZOchOBh8AlfMEP3_ffwBtSWbqQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>232311031</pqid></control><display><type>article</type><title>Autonomic dysfunction in systemic sclerosis: Sympathetic overactivity and instability</title><source>MEDLINE</source><source>Access via ScienceDirect (Elsevier)</source><creator>Dessein, Patrick H. ; Joffe, Barry I. ; Metz, Reeva M. ; Millar, Denise L. ; Lawson, Mary ; Stanwix, Anne E.</creator><creatorcontrib>Dessein, Patrick H. ; Joffe, Barry I. ; Metz, Reeva M. ; Millar, Denise L. ; Lawson, Mary ; Stanwix, Anne E.</creatorcontrib><description>purpose: This study was designed to assess the prevalence and nature of autonomic dysfunction (AD) in 34 patients with systemic sclerosis (SSc).
patients and methods: Patients were questioned for current symptoms possibly related to AD. Five noninvasive cardiovascular autonomic function tests and sequential plasma catecholamine estimations at rest, during standing, and during sustained handgrip were performed. Seven patients with manometrically documented esophageal involvement and high resting plasma adrenaline levels were treated with clonidine (75 to 375 μg/d). One month later, resting plasma catecholamine estimations and esophageal motility studies were repeated.
results: Autonomic testing revealed AD in each patient, while symptoms were experienced by 33 of them. Findings on two of the three heart rate tests and both blood pressure tests were significantly impaired as compared with those in 25 matched control subjects. Mean resting plasma adrenaline levels were 18 times higher than in 10 matched controls (p <0.001). Plasma catecholamine (adrenaline, noradrenaline, and dopamine) concentrations and mean arterial blood pressures fluctuated inappropriately during standing and sustained handgrip in 28 (82%) of the patients. The presence of headaches correlated significantly with sympathetic overactivity and instability (p <0.05). Resting plasma adrenaline concentrations correlated inversely with disease duration (p <0.05). Significant suppression of sympathetic overactivity and increases in resting lower esophageal sphincter pressures were observed in the seven patients treated with clonidine.
conclusion: AD is extremely common in SSc. It is characterized by parasympathetic impairment and marked sympathetic overactivity, particularly in early disease. The potential role of AD in the pathogenesis of SSc deserves further study.</description><identifier>ISSN: 0002-9343</identifier><identifier>EISSN: 1555-7162</identifier><identifier>DOI: 10.1016/0002-9343(92)90043-B</identifier><identifier>PMID: 1497010</identifier><identifier>CODEN: AJMEAZ</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Adult ; Aged ; Autonomic Nervous System - physiopathology ; Biological and medical sciences ; Blood Pressure - physiology ; Catecholamines - blood ; Esophagus - physiopathology ; Female ; Heart Rate - physiology ; Humans ; Male ; Manometry ; Medical research ; Medical sciences ; Middle Aged ; Multiple sclerosis ; Posture ; Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis ; Scleroderma, Systemic - blood ; Scleroderma, Systemic - physiopathology ; Sympathetic Nervous System - physiopathology</subject><ispartof>The American journal of medicine, 1992-08, Vol.93 (2), p.143-150</ispartof><rights>1992</rights><rights>1992 INIST-CNRS</rights><rights>Copyright Elsevier Sequoia S.A. Aug 1992</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c479t-8e2206723e8e46292896f25bd0b970e8a481b8195f35918865876d519997c50f3</citedby><cites>FETCH-LOGICAL-c479t-8e2206723e8e46292896f25bd0b970e8a481b8195f35918865876d519997c50f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/0002-9343(92)90043-B$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=5556660$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/1497010$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Dessein, Patrick H.</creatorcontrib><creatorcontrib>Joffe, Barry I.</creatorcontrib><creatorcontrib>Metz, Reeva M.</creatorcontrib><creatorcontrib>Millar, Denise L.</creatorcontrib><creatorcontrib>Lawson, Mary</creatorcontrib><creatorcontrib>Stanwix, Anne E.</creatorcontrib><title>Autonomic dysfunction in systemic sclerosis: Sympathetic overactivity and instability</title><title>The American journal of medicine</title><addtitle>Am J Med</addtitle><description>purpose: This study was designed to assess the prevalence and nature of autonomic dysfunction (AD) in 34 patients with systemic sclerosis (SSc).
patients and methods: Patients were questioned for current symptoms possibly related to AD. Five noninvasive cardiovascular autonomic function tests and sequential plasma catecholamine estimations at rest, during standing, and during sustained handgrip were performed. Seven patients with manometrically documented esophageal involvement and high resting plasma adrenaline levels were treated with clonidine (75 to 375 μg/d). One month later, resting plasma catecholamine estimations and esophageal motility studies were repeated.
results: Autonomic testing revealed AD in each patient, while symptoms were experienced by 33 of them. Findings on two of the three heart rate tests and both blood pressure tests were significantly impaired as compared with those in 25 matched control subjects. Mean resting plasma adrenaline levels were 18 times higher than in 10 matched controls (p <0.001). Plasma catecholamine (adrenaline, noradrenaline, and dopamine) concentrations and mean arterial blood pressures fluctuated inappropriately during standing and sustained handgrip in 28 (82%) of the patients. The presence of headaches correlated significantly with sympathetic overactivity and instability (p <0.05). Resting plasma adrenaline concentrations correlated inversely with disease duration (p <0.05). Significant suppression of sympathetic overactivity and increases in resting lower esophageal sphincter pressures were observed in the seven patients treated with clonidine.
conclusion: AD is extremely common in SSc. It is characterized by parasympathetic impairment and marked sympathetic overactivity, particularly in early disease. The potential role of AD in the pathogenesis of SSc deserves further study.</description><subject>Adult</subject><subject>Aged</subject><subject>Autonomic Nervous System - physiopathology</subject><subject>Biological and medical sciences</subject><subject>Blood Pressure - physiology</subject><subject>Catecholamines - blood</subject><subject>Esophagus - physiopathology</subject><subject>Female</subject><subject>Heart Rate - physiology</subject><subject>Humans</subject><subject>Male</subject><subject>Manometry</subject><subject>Medical research</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Multiple sclerosis</subject><subject>Posture</subject><subject>Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis</subject><subject>Scleroderma, Systemic - blood</subject><subject>Scleroderma, Systemic - physiopathology</subject><subject>Sympathetic Nervous System - physiopathology</subject><issn>0002-9343</issn><issn>1555-7162</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1992</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kUuLFTEQhYMo453Rf6DQiAy6aM2j83IhzAy-YMCFzjqk09WYoTu5JukL_e9Ncy8juHBVVNV3ipMThF4Q_I5gIt5jjGmrWcfeaPpWY9yx9voR2hHOeSuJoI_R7gF5is5zvq8t1lycoTPSaYkJ3qG7q6XEEGfvmmHN4xJc8TE0PjR5zQW2eXYTpJh9_tD8WOe9Lb-g1HE8QLKVPviyNjYMVZOL7f1U-2foyWinDM9P9QLdff708-Zre_v9y7ebq9vWdVKXVgGlWEjKQEEnqKZKi5HyfsB9tQfKdor0img-Mq6JUoIrKQZOtNbScTyyC3R5vLtP8fcCuZjZZwfTZAPEJRvJCJZaygq--ge8j0sK1ZuhjDJCMCMV6o6Qq8_NCUazT362aTUEmy1ys-VptjyNrnWL3FxX2cvT7aWfYfgrOmZc969Pe5udncZkg_P5AavfJYTYsI9HDGpgBw_JZOchOBh8AlfMEP3_ffwBtSWbqQ</recordid><startdate>19920801</startdate><enddate>19920801</enddate><creator>Dessein, Patrick H.</creator><creator>Joffe, Barry I.</creator><creator>Metz, Reeva M.</creator><creator>Millar, Denise L.</creator><creator>Lawson, Mary</creator><creator>Stanwix, Anne E.</creator><general>Elsevier Inc</general><general>Elsevier</general><general>Elsevier Sequoia S.A</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7TK</scope><scope>7TO</scope><scope>7TS</scope><scope>7U9</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>19920801</creationdate><title>Autonomic dysfunction in systemic sclerosis: Sympathetic overactivity and instability</title><author>Dessein, Patrick H. ; Joffe, Barry I. ; Metz, Reeva M. ; Millar, Denise L. ; Lawson, Mary ; Stanwix, Anne E.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c479t-8e2206723e8e46292896f25bd0b970e8a481b8195f35918865876d519997c50f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1992</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Autonomic Nervous System - physiopathology</topic><topic>Biological and medical sciences</topic><topic>Blood Pressure - physiology</topic><topic>Catecholamines - blood</topic><topic>Esophagus - physiopathology</topic><topic>Female</topic><topic>Heart Rate - physiology</topic><topic>Humans</topic><topic>Male</topic><topic>Manometry</topic><topic>Medical research</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Multiple sclerosis</topic><topic>Posture</topic><topic>Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis</topic><topic>Scleroderma, Systemic - blood</topic><topic>Scleroderma, Systemic - physiopathology</topic><topic>Sympathetic Nervous System - physiopathology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Dessein, Patrick H.</creatorcontrib><creatorcontrib>Joffe, Barry I.</creatorcontrib><creatorcontrib>Metz, Reeva M.</creatorcontrib><creatorcontrib>Millar, Denise L.</creatorcontrib><creatorcontrib>Lawson, Mary</creatorcontrib><creatorcontrib>Stanwix, Anne E.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Physical Education Index</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Dessein, Patrick H.</au><au>Joffe, Barry I.</au><au>Metz, Reeva M.</au><au>Millar, Denise L.</au><au>Lawson, Mary</au><au>Stanwix, Anne E.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Autonomic dysfunction in systemic sclerosis: Sympathetic overactivity and instability</atitle><jtitle>The American journal of medicine</jtitle><addtitle>Am J Med</addtitle><date>1992-08-01</date><risdate>1992</risdate><volume>93</volume><issue>2</issue><spage>143</spage><epage>150</epage><pages>143-150</pages><issn>0002-9343</issn><eissn>1555-7162</eissn><coden>AJMEAZ</coden><abstract>purpose: This study was designed to assess the prevalence and nature of autonomic dysfunction (AD) in 34 patients with systemic sclerosis (SSc).
patients and methods: Patients were questioned for current symptoms possibly related to AD. Five noninvasive cardiovascular autonomic function tests and sequential plasma catecholamine estimations at rest, during standing, and during sustained handgrip were performed. Seven patients with manometrically documented esophageal involvement and high resting plasma adrenaline levels were treated with clonidine (75 to 375 μg/d). One month later, resting plasma catecholamine estimations and esophageal motility studies were repeated.
results: Autonomic testing revealed AD in each patient, while symptoms were experienced by 33 of them. Findings on two of the three heart rate tests and both blood pressure tests were significantly impaired as compared with those in 25 matched control subjects. Mean resting plasma adrenaline levels were 18 times higher than in 10 matched controls (p <0.001). Plasma catecholamine (adrenaline, noradrenaline, and dopamine) concentrations and mean arterial blood pressures fluctuated inappropriately during standing and sustained handgrip in 28 (82%) of the patients. The presence of headaches correlated significantly with sympathetic overactivity and instability (p <0.05). Resting plasma adrenaline concentrations correlated inversely with disease duration (p <0.05). Significant suppression of sympathetic overactivity and increases in resting lower esophageal sphincter pressures were observed in the seven patients treated with clonidine.
conclusion: AD is extremely common in SSc. It is characterized by parasympathetic impairment and marked sympathetic overactivity, particularly in early disease. The potential role of AD in the pathogenesis of SSc deserves further study.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>1497010</pmid><doi>10.1016/0002-9343(92)90043-B</doi><tpages>8</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0002-9343 |
| ispartof | The American journal of medicine, 1992-08, Vol.93 (2), p.143-150 |
| issn | 0002-9343 1555-7162 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_73107977 |
| source | MEDLINE; Access via ScienceDirect (Elsevier) |
| subjects | Adult Aged Autonomic Nervous System - physiopathology Biological and medical sciences Blood Pressure - physiology Catecholamines - blood Esophagus - physiopathology Female Heart Rate - physiology Humans Male Manometry Medical research Medical sciences Middle Aged Multiple sclerosis Posture Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis Scleroderma, Systemic - blood Scleroderma, Systemic - physiopathology Sympathetic Nervous System - physiopathology |
| title | Autonomic dysfunction in systemic sclerosis: Sympathetic overactivity and instability |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-24T22%3A48%3A42IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Autonomic%20dysfunction%20in%20systemic%20sclerosis:%20Sympathetic%20overactivity%20and%20instability&rft.jtitle=The%20American%20journal%20of%20medicine&rft.au=Dessein,%20Patrick%20H.&rft.date=1992-08-01&rft.volume=93&rft.issue=2&rft.spage=143&rft.epage=150&rft.pages=143-150&rft.issn=0002-9343&rft.eissn=1555-7162&rft.coden=AJMEAZ&rft_id=info:doi/10.1016/0002-9343(92)90043-B&rft_dat=%3Cproquest_cross%3E5758692%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=232311031&rft_id=info:pmid/1497010&rft_els_id=000293439290043B&rfr_iscdi=true |