Blood pressure variability and baroreflex sensitivity of a healthy male during cold pressor test that induced development of neurocardiogenic syncope

Biswajit Sinha; Dinesh K. Dubey

doi:10.1515/jbcpp-2015-0004

Article

Blood pressure variability and baroreflex sensitivity of a healthy male during cold pressor test that induced development of neurocardiogenic syncope

Biswajit Sinha and Dinesh K. Dubey

Published/Copyright: March 23, 2016

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From the journal Journal of Basic and Clinical Physiology and Pharmacology Volume 27 Issue 4

Abstract

Background: The cold pressor test (CPT) is a recognized physiological technique to evaluate autonomic cardiovascular function. The present case study assessed the cardiovascular response of a healthy adult male during 3 min of CPT.

Methods: Heart rate (HR) by single-lead electrocardiography and blood pressure (BP) by an arterial tonometer of the participant on a beat-to-beat basis were recorded before and during CPT.

Results: HR during CPT showed a biphasic pattern with an initial increase from baseline (86 bpm) to the first 30 s of CPT (93 bpm) followed by a decrease. It dropped to 51 bpm during the last 30 s of CPT. Systolic blood pressure (SBP) increased from baseline (110 mmHg) to 1 min (122 mmHg) followed by a decrease. SBP immediately after CPT reduced to 57 mmHg. Diastolic blood pressure (DBP) from baseline (71 mmHg) slightly increased to 75 mmHg up to 90 s of the test, thereafter it registered a fall, and during the last 30 s of CPT, DBP fell to 30 mmHg. Stroke volume increased from baseline (75 mL/min) to the first 30 s (99 mL/min), followed by a slight reduction which was maintained till last of the test (70 mL/min). Cardiac output after an initial increase from baseline (6.4 L/min) to the first 30 s (9.2 L/min) decreased to 4.1 L/min during the last 30 s of the test. Baroreflex sensitivity (BRS) from baseline (9.32 ms/mmHg) plummeted to 6.67 ms/mmHg during the first 30 s of CPT followed by an increase, and after CPT, BRS was increased to 15.23 ms/mmHg. Other cardiovascular parameters such as myocardial contractility (dp/dt), total peripheral resistance, and mean arterial pressure were reduced in the individual at the time of loss of consciousness that occurred at the end of the last 30 s of CPT.

Conclusions: The present case study described the modulation of cardiovascular functions of a healthy male during CPT, which finally led to the development of neurocardiogenic syncope characterized by hypotension and bradycardia.

Keywords: autonomic function; baroreflex sensitivity; blood pressure variability; cold pressor test; syncope

Corresponding author: Dr. Prof. Biswajit Sinha, Department of Physiology, Institute of Aerospace Medicine IAF, Bangalore-560017, India, Phone: 09342347428, Fax: +91-80-25224659, E-mail: bsinha2001@yahoo.co.in

Acknowledgments

The authors are thankful to Dr. D. Dey, Assistant Professor, Department of Physiology, AFMC, Pune, India, for his assistance during the conduct of the study. The authors are grateful to the volunteer who participated in the study. The study was carried out as a departmental project, and no funding was received from any of the internal or external agencies.

Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.
Research funding: None declared.
Employment or leadership: None declared.
Honorarium: None declared.
Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

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Received: 2015-1-11

Accepted: 2016-2-2

Published Online: 2016-3-23

Published in Print: 2016-6-1

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Articles in the same Issue

https://doi.org/10.1515/jbcpp-2015-0004

Keywords for this article

autonomic function; baroreflex sensitivity; blood pressure variability; cold pressor test; syncope