Key result
A multidisciplinary approach to the study of the pathophysiology of vasovagal syncope may yield new insights into its hemodynamic, hormonal, and psychological mechanisms.
Understanding the complex interplay of hemodynamic, hormonal, and psychological factors in vasovagal syncope highlights the need for a multidisciplinary approach to its pathophysiology.
Refines orthostatic VVS hemodynamics via SV quantification; leaves open targeted therapies for emotional triggers pending validation.
The pathophysiology of vasovagal syncope (VVS) is reviewed, focusing on hemodynamic aspects. Much more is known about orthostatic than about emotional VVS, probably because the former can be studied using a tilt table test (TTT). Recent advances made it possible to quantify the relative contributions of the three factors that control blood pressure: heart rate (HR), stroke volume (SV) and total peripheral resistance (TPR). Orthostatic VVS starts with venous pooling, reflected in a decrease of SV. This is followed by cardioinhibition (CI), which is a decrease of HR that accelerates the ongoing decrease of BP, making the start of CI a literal as well as fundamental turning point. The role of hormonal and other humoral factors, respiration and of psychological influences is reviewed in short, leading to the conclusion that a multidisciplinary approach to the study of the pathophysiology of VVS may yield new insights.
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Dijk et al. (2021) conducted a review in Vasovagal syncope. A multidisciplinary approach to the study of the pathophysiology of vasovagal syncope may yield new insights into its hemodynamic, hormonal, and psychological mechanisms.
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