What Is the Role of Neurohumoral Agents in the Genesis of Vasovagal Syncope?

  • P. Alboni
  • M. Dinelli
  • E. Degli Uberti


Arterial and cardiopulmonary baroceptor reflexes are the major neural control mechanisms that regulate arterial pressure and vascular tone in humans.


Carotid Sinus Vasovagal Syncope Fluoxetine Hydrochloride Carotid Sinus Hypersensitivity Vasodepressor Response 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Yamamoto M, Sato H, Abe S et al (1993) Unusual increase in sympathetic nervous activity preceding syncope in patients with neurally mediated syncope. Circulation 88:I-44 (abstr)Google Scholar
  2. 2.
    Sahalev Y, Gal R, Tchou P et al (1991) Echocardiographic demonstration of decreased left ventricular dimensions and vigorous myocardial contraction during syncope induced by head upright tilt. J Am Coll Cardiol 18: 748–751Google Scholar
  3. 3.
    Fitzpatrick A, Williams T, Ahmed R, Lightman S, Bloom SR, Sutton R (1992) Echocardiographic and endocrine changes during vasovagal syncope induced by prolonged head-up tilt. Eur J Cardiac Pacing Electrophysiol 2: 121–128Google Scholar
  4. 4.
    Lewis T (1932) A lecture in vasovagal syncope and the carotid sinus mechanism. Br Med J 28: 873–876CrossRefGoogle Scholar
  5. 5.
    Grubb BP, Gerard G, Roush K et al (1992) Cerebral vasoconstriction during head upright tilt induced vasovagal syncope. A paradoxic and unexpected response. Circulation 84: 1157–1164CrossRefGoogle Scholar
  6. 6.
    Chosy JJ, Graham DT (1965) Catecholamines in vasovagal fainting. J Psychosom Res 9: 189–194PubMedCrossRefGoogle Scholar
  7. 7.
    Perry JC, Gerson A Jr (1991) The child with recurrent syncope: autonomic function testing and beta-adrenergic hypersensitivity. J Am Coll Cardiol 17: 1168–1171PubMedCrossRefGoogle Scholar
  8. 8.
    Balaji S, Allen M, McKay C et al (1993) Endogenous catecholamine levels during orthostatic stress induced syncope in children. Circulation 88:I-399 (abstr)Google Scholar
  9. 9.
    Sra JS, Murthy V, Natale A et al (1994) Circulatory and catecholamine changes during head-up tilt testing in neurocardiogenic (vasovagal) syncope. Am J Cardiol 73: 33–37PubMedCrossRefGoogle Scholar
  10. 10.
    Smith GDP, Watson LP, Mathias CJ (1996) Cardiovascular and catecholamine changes induced by supine exercise and upright posture in vasovagal syncope. Eur Heart J 17: 1882–1890PubMedCrossRefGoogle Scholar
  11. 11.
    Perna GP, Ficola U, Salvatori MP et al (1990) Increase in plasma beta endorphins in vasodepressor syncope. Am J Cardiol 65: 929–930PubMedCrossRefGoogle Scholar
  12. 12.
    Morita M, Nishida Y, Motochigawa H, Uemura N, Hosomi H, Vatner SF (1988) Opiate receptor-mediated decrease in renal nerve activity during hypotensive hemorrhage in conscious rabbits. Circ Res 63: 165–172PubMedCrossRefGoogle Scholar
  13. 13.
    Evans RG, Ludbrook J, Potocnik SJ (1989) Intracisternal naloxone and cardiac nerve blockade prevent vasodilatation during simulated haemorrhage in awake rabbits. J Physiol 409: 1–14PubMedGoogle Scholar
  14. 14.
    Schobel HP, Oren RN, Mark AL, Ferguson DW (1992) Naloxone potentiates cardiopulmonary baroreflex sympathetic control in normal humans. Circ Res 70: 172–183PubMedCrossRefGoogle Scholar
  15. 15.
    Wallbridge DR, Maclntyre HE, Gray CE et al (1994) Increase in plasma 13 endorphins precedes vasodepressor syncope. Br Heart J 71: 446–448PubMedCrossRefGoogle Scholar
  16. 16.
    Wallbridge DR, Maclntyre HE, Gray CE, Oldroyd KG, Rae AP, Cobbe SM (1996) Role of endogenous opioids and catecholamines in vasovagal syncope. Eur Heart J 17: 1729–1736PubMedCrossRefGoogle Scholar
  17. 17.
    Morgan DA, Thoren P, Wilczynski EA, Victor RG, Mark AL (1988) Serotonergic mechanisms mediate renal sympathoinhibition during severe hemorrhage in rats. Am J Physiol 255: 496–502Google Scholar
  18. 18.
    Kosinski D, Grubb B, Temesy-Armos P (1995) Pathophysiological aspects of neurocardiogenic syncope: current concepts and new perspectives. PACE 18: 716–724PubMedCrossRefGoogle Scholar
  19. 19.
    Elam RF, Bergman F, Feverstein G (1985) The use of antiserotonergic agents for the treatment of acute hemorrhagic shock in cats. Eur J Pharmacol 107: 275–278PubMedCrossRefGoogle Scholar
  20. 20.
    Evans RG, Kapoor V, Ludbrook J (1992) A CNS serotonergic mechanism in acute central hypovolemia in conscious rabbits?. J Cardiovasc Pharmacol 19: 1009–1017PubMedCrossRefGoogle Scholar
  21. 21.
    Grubb BP, Wolfe D, Samoil D et al (1992) Usefulness of fluoxetine hydrochloride for prevention of upright tilt-induced syncope. PACE 15: 742–748PubMedCrossRefGoogle Scholar
  22. 22.
    Grubb BP, Kosinski DJ (1995) Serotonin and syncope: an emerging connection?. Eur J Cardiac Pacing Electrophysiol 5: 306–314Google Scholar

Copyright information

© Springer-Verlag Italia 1998

Authors and Affiliations

  • P. Alboni
    • 1
  • M. Dinelli
    • 1
  • E. Degli Uberti
    • 2
  1. 1.Divisione di CardiologiaOspedale CivileCento (FE)Italy
  2. 2.Dipartimento di Scienze Biomediche e Terapia Avanzata, Sezione di EndocrinologiaUniversità degli Studi di FerraraItaly

Personalised recommendations