title: The influence of a tilt training programme on the renin-angiotensin-aldosterone system activity in patients with vasovagal syncope.
abstract: OBJECTIVE
  We assessed the influence of short-term and long-term tilt training on the activity of the renin-angiotensin-aldosterone system (RAAS) in vasovagal patients.
  
  
  RESULTS
  Thirty-nine patients (28 F, 11 M) aged 39.7 +/- 11.2 years with a history of vasovagal syncope and a positive head-up tilt test (HUT) were studied. Blood samples for plasma renin activity (PRA) and aldosterone (ALDO) concentration were drawn at the baseline, immediately after HUT and 10 min after HUT, during the diagnostic, the negative short-term (2-5 days) follow-up HUT and long-term (1-3 months) follow-up HUT. Tilt training was started after diagnostic HUT. In diagnostic HUT, PRA increased significantly immediately after HUT comparing to the baseline, during recovery the values did not change. ALDO concentration increased after HUT comparing to baseline and further increased during recovery. After short-term tilt training, PRA and ALDO concentrations did not significantly change compared to their corresponding values in diagnostic HUT. After long-term tilt training, PRA did not significantly change compared to the values in the diagnostic and short-term follow-up HUT. ALDO concentration also did not change significantly at the baseline and immediately after HUT, and 10 min after HUT ALDO concentration was significantly lower than after diagnostic HUT.
  
  
  CONCLUSIONS
  Tilt training changes the response of RAAS to the prolonged orthostasis in vasovagal patients. The coupling between PRA and ALDO after diagnostic HUT has been found to be altered and the physiological relationship was restored after long-term tilt training. The beneficial effect of tilt training depends partially on changed RAAS activation.
authors.affiliation: Department of Cardiology, Wroclaw Medical University, Poland. gajek33@interia.pl
authors.forename: Jacek
authors.initials: J
authors.lastname: Gajek
authors.forename: Dorota
authors.initials: D
authors.lastname: Zyśko
authors.forename: Sylwia
authors.initials: S
authors.lastname: Krzemińska
authors.forename: Walentyna
authors.initials: W
authors.lastname: Mazurek
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000450:Aldosterone / Q000097:blood; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D026741:Physical Therapy Modalities; D012083:Renin / Q000097:blood; D012084:Renin-Angiotensin System / Q000502:physiology*; D019462:Syncope, Vasovagal / Q000503:physiopathology / Q000628:therapy*
chemical_list: D000450:Aldosterone; D012083:Renin