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© 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.

Abstract

(1) Background: The autonomic imbalance plays a role in vasovagal syncope (VVS) diagnosed by head-up tilting test (HUT). neuECG is a new method of recording skin electrical signals to simultaneously analyze skin sympathetic nerve activity (SKNA) and electrocardiogram. We hypothesize that SKNA is higher in subjects with tilt-positive than tilt-negative and the SKNA surges before syncope. (2) Methods: We recorded neuECG in 41 subjects who received HUT (according to the “Italian protocol”), including rest, tilt-up, provocation and recovery phases. Data were analyzed to determine the average SKNA (aSKNA, μV) per digitized sample. Electrocardiogram was used to calculate standard deviation of normal-to-normal beat intervals (SDNN). The “SKNA-SDNN index” was calculated by rest aSKNA multiplied by the ratio of tilt-up to rest SDNN. (3) Results: 16 of 41 (39%) subjects developed syncope. The aSKNA at rest phase is significantly higher in the tilt-positive (1.21 ± 0.27 µV) than tilt-negative subjects (1.02 ± 0.29 µV) (p = 0.034). There are significant surges and withdraw of aSKNA 30 s before and after syncope (both p ≤ 0.006). SKNA-SDNN index is able to predict syncope (p < 0.001). (4) Conclusion: Higher SKNA at rest phase is associated with positive HUT. The SKNA-SDNN index is a novel marker to predict syncope during HUT.

Details

Title
High Skin Sympathetic Nerve Activity in Patients with Recurrent Syncope
Author
Tien-Chi, Huang 1   VIAFID ORCID Logo  ; Nai-Yu, Chi 1 ; Chih-Sung, Lan 1 ; Chang-Jen, Chen 2 ; Shih-Jie Jhuo 1   VIAFID ORCID Logo  ; Tsung-Han, Lin 3 ; Yi-Hsueh, Liu 4   VIAFID ORCID Logo  ; Li-Fang, Chou 1 ; Chien-Wei, Chang 1 ; Wei-Sheng, Liao 1 ; Pei-Heng Kao 1 ; Po-Chao Hsu 5   VIAFID ORCID Logo  ; Chee-Siong, Lee 5 ; Yi-Hsiung, Lin 1   VIAFID ORCID Logo  ; Hsiang-Chun, Lee 5   VIAFID ORCID Logo  ; Ye-Hsu, Lu 1 ; Hsueh-Wei, Yen 5 ; Lin, Tsung-Hsien 5   VIAFID ORCID Logo  ; Ho-Ming, Su 6   VIAFID ORCID Logo  ; Wen-Ter Lai 1 ; Wei-Chung, Tsai 5   VIAFID ORCID Logo  ; Lin, Shien-Fong 7 ; Chien-Hung, Lee 8   VIAFID ORCID Logo 

 Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan; [email protected] (T.-C.H.); [email protected] (N.-Y.C.); [email protected] (C.-S.L.); [email protected] (S.-J.J.); [email protected] (T.-H.L.); [email protected] (Y.-H.L.); [email protected] (L.-F.C.); [email protected] (C.-W.C.); [email protected] (W.-S.L.); [email protected] (P.-H.K.); [email protected] (P.-C.H.); [email protected] (C.-S.L.); [email protected] (Y.-H.L.); [email protected] (H.-C.L.); [email protected] (Y.-H.L.); [email protected] (H.-W.Y.); [email protected] (T.-H.L.); [email protected] (H.-M.S.); [email protected] (W.-T.L.) 
 Division of Cardiology, Department of Internal Medicine, Show Chwan Memorial Hospital, Changhua 500, Taiwan; [email protected] 
 Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan; [email protected] (T.-C.H.); [email protected] (N.-Y.C.); [email protected] (C.-S.L.); [email protected] (S.-J.J.); [email protected] (T.-H.L.); [email protected] (Y.-H.L.); [email protected] (L.-F.C.); [email protected] (C.-W.C.); [email protected] (W.-S.L.); [email protected] (P.-H.K.); [email protected] (P.-C.H.); [email protected] (C.-S.L.); [email protected] (Y.-H.L.); [email protected] (H.-C.L.); [email protected] (Y.-H.L.); [email protected] (H.-W.Y.); [email protected] (T.-H.L.); [email protected] (H.-M.S.); [email protected] (W.-T.L.); Department of Internal Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung 801, Taiwan 
 Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan; [email protected] (T.-C.H.); [email protected] (N.-Y.C.); [email protected] (C.-S.L.); [email protected] (S.-J.J.); [email protected] (T.-H.L.); [email protected] (Y.-H.L.); [email protected] (L.-F.C.); [email protected] (C.-W.C.); [email protected] (W.-S.L.); [email protected] (P.-H.K.); [email protected] (P.-C.H.); [email protected] (C.-S.L.); [email protected] (Y.-H.L.); [email protected] (H.-C.L.); [email protected] (Y.-H.L.); [email protected] (H.-W.Y.); [email protected] (T.-H.L.); [email protected] (H.-M.S.); [email protected] (W.-T.L.); Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung 812, Taiwan 
 Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan; [email protected] (T.-C.H.); [email protected] (N.-Y.C.); [email protected] (C.-S.L.); [email protected] (S.-J.J.); [email protected] (T.-H.L.); [email protected] (Y.-H.L.); [email protected] (L.-F.C.); [email protected] (C.-W.C.); [email protected] (W.-S.L.); [email protected] (P.-H.K.); [email protected] (P.-C.H.); [email protected] (C.-S.L.); [email protected] (Y.-H.L.); [email protected] (H.-C.L.); [email protected] (Y.-H.L.); [email protected] (H.-W.Y.); [email protected] (T.-H.L.); [email protected] (H.-M.S.); [email protected] (W.-T.L.); Department of Internal Medicine, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan 
 Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan; [email protected] (T.-C.H.); [email protected] (N.-Y.C.); [email protected] (C.-S.L.); [email protected] (S.-J.J.); [email protected] (T.-H.L.); [email protected] (Y.-H.L.); [email protected] (L.-F.C.); [email protected] (C.-W.C.); [email protected] (W.-S.L.); [email protected] (P.-H.K.); [email protected] (P.-C.H.); [email protected] (C.-S.L.); [email protected] (Y.-H.L.); [email protected] (H.-C.L.); [email protected] (Y.-H.L.); [email protected] (H.-W.Y.); [email protected] (T.-H.L.); [email protected] (H.-M.S.); [email protected] (W.-T.L.); Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung 812, Taiwan; Department of Internal Medicine, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan 
 Institute of Biomedical Engineering, National Chiao Tung University, Hsinchu 300, Taiwan; [email protected] 
 Department of Public Health, College of Health Science, Kaohsiung Medical University, Kaohsiung 807, Taiwan; [email protected]; Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan 
First page
1053
Publication year
2021
Publication date
2021
Publisher
MDPI AG
e-ISSN
20754426
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
2602102184
Copyright
© 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.