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The hemodynamic pattern of the syndrome of delayed orthostatic hypotension

  • Cristian Podoleanu
  • Roberto Maggi
  • Daniele Oddone
  • Alberto Solano
  • Paolo Donateo
  • Francesco Croci
  • Emilian Carasca
  • Carmen Ginghina
  • Michele Brignole
Article

Abstract

Purpose

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.

Conclusion

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.

Keywords

Delayed orthostatic hypotension Progressive orthostatic hypotension Compression bandage Non-invasive monitoring Blood pressure Total peripheral resistance 

Notes

Acknowledgments

Cristian Podoleanu, Emilian Carasca, and Carmen Ginghina were supported by the National University Research Council of Romania (grant CNCSIS 1125/2007).

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Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  • Cristian Podoleanu
    • 1
    • 4
  • Roberto Maggi
    • 2
  • Daniele Oddone
    • 2
  • Alberto Solano
    • 2
  • Paolo Donateo
    • 2
  • Francesco Croci
    • 2
  • Emilian Carasca
    • 1
  • Carmen Ginghina
    • 3
  • Michele Brignole
    • 2
  1. 1.Cardiology Department, 4th Medical ClinicUniversity of Medicine and Pharmacy Targu MuresStr. Gh. Marinescu 1Targu MuresRomania
  2. 2.Arrhythmologic Centre, Cardiology DepartmentOspedali del TigullioLavagna (GE)Italy
  3. 3.CC Iliescu Heart InstituteUniversity of Medicine and Pharmacy BucharestBucharestRomania
  4. 4.Targu MuresRomania

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