The role of adrenomedullin and galanin in recurrent vasovagal syncope: a case control study.
OBJECTIVE
Orthostatic stimuli are known to elicit changes in vasoactive peptide levels. The hypothesis of no difference in adrenomedullin and/or galanin levels in patients with recurrent vasovagal syncope and healthy controls was tested in a passive 35-min head-up tilt test (HUTT).


METHODS
Twenty eight persons (14 patients and 14 healthy controls) were tested in a 35-min/60° head-up tilt test with telemetry monitoring. Three blood samples were evaluated for each person during the HUTT. Plasma levels of adrenomedullin and galanin were analysed by the Kruskal-Wallis test for all sampling periods. Vagal influence was indirectly assessed by the break index.


RESULTS
There were no significant differences between groups in median values for either adrenomedullin or galanin plasma levels (all 6 p-values were greater than 0.4). For adrenomedullin, no significant difference between groups was found. For galanin, the rate of change between the 1st and 2nd measurement was significantly greater for patients (P=0.04), regardless of HUTT result but between the 2(nd) and 3(rd) measurement it was insignificant (P=0.36). In the group of positive cases, the break index increased significantly (P=0.02).


CONCLUSIONS
We confirmed that there is a different galanin secretion pattern during orthostatic provocation in patients with recurrent vasovagal syncope than healthy individuals. For adrenomedullin, no significant difference was found. A significant increment of the break index confirmed increased vagal influence in the subgroup of positive cases.
Clinic of Internal Medicine, University Hospital Ostrava and Faculty of Medicine, University of Ostrava, Czech Republic.
Jiri
J
Plasek
Vlastimil
V
Doupal
Jana
J
Furstova
Tomas
T
Furst
Kristian
K
Safarcik
Alena
A
Krnacova
Nadezda
N
Petejova
Zuzana
Z
Hrabovska
Arnost
A
Martinek
Milos
M
Taborsky
D053607:Adrenomedullin / Q000097:blood*; D000328:Adult; D001794:Blood Pressure / Q000502:physiology; D016022:Case-Control Studies; D005260:Female; D019004:Galanin / Q000097:blood*; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011187:Posture; D019462:Syncope, Vasovagal / Q000097:blood*; D018667:Tilt-Table Test / Q000379:methods; D055815:Young Adult
D053607:Adrenomedullin; D019004:Galanin