The hemodynamic pattern of the syndrome of delayed orthostatic hypotension.
OBJECTIVE
We investigated the hemodynamic mechanisms underlying the syndrome of delayed orthostatic hypotension (OH) and the hemodynamic effect of the treatment with leg compression bandages.


METHODS
Non-invasive monitoring of systolic blood pressure (SBP), heart rate (HR), cardiac output (CO), stroke volume (SV), and total peripheral resistance (TPR) was performed during tilt testing in patients affected by delayed OH compared to age- and sex-matched controls. Thirteen patients (68 +/- 14 years) and nine controls (68 +/- 8 years) were studied.


RESULTS
Immediately after tilt-up, SBP progressively decreased in patients but not in controls. Symptoms developed at 100 +/- 7 mmHg. At the end of the test, SBP was significantly lower in patients than in controls. TPR progressively decreased in patients but not in controls. SV and CO did not change significantly. HR increased progressively in the patients until the end of the test and remained unchanged in controls. Active treatment with compression bandages avoided the decrease in SBP and TPR, while CO showed minimal variation.


CONCLUSIONS
In patients affected by delayed OH, the progressive decrease of SBP is associated with progressive decrease of TPR, while CO and SV show little variation; the compensatory increase in HR is insufficient to compensate for the decline in blood pressure.
Podoleanu
Cristian
C
Cardiology Department, 4th Medical Clinic, University of Medicine and Pharmacy Targu Mures, Str. Gh. Marinescu 1, 540099, Targu Mures, Romania. podoleanu@gmx.net
Maggi
Roberto
R
Oddone
Daniele
D
Solano
Alberto
A
Donateo
Paolo
P
Croci
Francesco
F
Carasca
Emilian
E
Ginghina
Carmen
C
Brignole
Michele
M
D000368:Aged; D001783:Blood Flow Velocity; D001794:Blood Pressure; D002302:Cardiac Output; D005260:Female; D006339:Heart Rate; D006801:Humans; D007024:Hypotension, Orthostatic / Q000503:physiopathology*; D008297:Male; D008955:Models, Cardiovascular; D013318:Stroke Volume; D013577:Syndrome; D014655:Vascular Resistance