TY - JOUR
T1 - Pathophysiological aspects of carotid sinus massage
AU - van Dijk, J. Gert
AU - Gagaouzova, Boriana S.
AU - de Jong, Jelle S. Y.
AU - van Rossum, Ineke A.
AU - van Houwelingen, Marc J.
AU - Kerkhof, Fabian I.
AU - Reijntjes, Robert H.
AU - Paton, Julian F. R.
AU - de Lange, Frederik J.
AU - Thijs, Roland D.
N1 - Publisher Copyright:
© The Author(s) 2025.
PY - 2025/4/1
Y1 - 2025/4/1
N2 - Methods We measured BP, heart rate (HR), stroke volume, and total peripheral resistance (TPR) retrospectively in carotid sinus mas- and results sage cohorts in two Dutch syncope centres. Cardioinhibition and aVD were defined as HR and TPR decreasing below 3 SD under pre-massage baseline means. We used the logratio method to analyse changes relative to baseline and tested whether CI and aVD occurred together more often than through chance and whether the responses depended on massage duration and on corrective BP increases. Cardioinhibition occurred in 48% and aVD in 30% of 244 massages of 90 persons. Cardioinhibition and aVD did not occur together more often than randomly. Compared with aVD, CI occurred more often, earlier, faster, and shorter with a larger maximal but similar overall BP-decreasing effect. Longer massage duration yielded a larger BP decrease through stronger aVD. The BP decrease evoked corrective increases of HR and TPR.Aims We studied the blood pressure (BP) decrease after carotid sinus massage to study cardioinhibition (CI) and arterial vasodepression (aVD), whether CI and aVD occur independent of one another, and how the BP decrease ends.Conclusion Cardioinhibition appears as a phasic response to the onset of massage, independent of aVD, which is a more latent response sensitive to ongoing massage. Blood pressure corrections probably depend on the contralateral carotid sinus and aortic baroreceptors. The BP decrease after sinus massage may in part depend on the efficacy of corrective responses.
AB - Methods We measured BP, heart rate (HR), stroke volume, and total peripheral resistance (TPR) retrospectively in carotid sinus mas- and results sage cohorts in two Dutch syncope centres. Cardioinhibition and aVD were defined as HR and TPR decreasing below 3 SD under pre-massage baseline means. We used the logratio method to analyse changes relative to baseline and tested whether CI and aVD occurred together more often than through chance and whether the responses depended on massage duration and on corrective BP increases. Cardioinhibition occurred in 48% and aVD in 30% of 244 massages of 90 persons. Cardioinhibition and aVD did not occur together more often than randomly. Compared with aVD, CI occurred more often, earlier, faster, and shorter with a larger maximal but similar overall BP-decreasing effect. Longer massage duration yielded a larger BP decrease through stronger aVD. The BP decrease evoked corrective increases of HR and TPR.Aims We studied the blood pressure (BP) decrease after carotid sinus massage to study cardioinhibition (CI) and arterial vasodepression (aVD), whether CI and aVD occur independent of one another, and how the BP decrease ends.Conclusion Cardioinhibition appears as a phasic response to the onset of massage, independent of aVD, which is a more latent response sensitive to ongoing massage. Blood pressure corrections probably depend on the contralateral carotid sinus and aortic baroreceptors. The BP decrease after sinus massage may in part depend on the efficacy of corrective responses.
KW - Baroreflex
KW - Cardioinhibition
KW - Carotid sinus massage
KW - Syncope
KW - Vasodepression
UR - https://www.scopus.com/pages/publications/105002494636
U2 - 10.1093/europace/euaf047
DO - 10.1093/europace/euaf047
M3 - Article
C2 - 40103329
SN - 1099-5129
VL - 27
JO - EP Europace
JF - EP Europace
IS - 4
M1 - euaf047
ER -
