April 1, 1994Cardiovascular Research
Reduced pain during baroreceptor stimulation in patients with symptomatic and silent myocardial ischaemia
Key result
PRES carotid baroreceptor manipulation reduces electrical pain intensity during maximum activity regardless of ischemia symptoms.
- F=37.8
- P<0.001
- n=19
Why the study?
Does baroreceptor stimulation differentially affect pain thresholds in patients with symptomatic versus silent myocardial ischaemia?
Population
19 patients with replicable myocardial ischaemia (9 symptomatic and 10 asymptomatic)
Comparison
PRES carotid baroreceptor manipulation vs Symptomatic vs asymptomatic patients; comparison…
Design
Cross-sectional
Authors
Discussion
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Implication
Baroreceptor-dependent pain inhibition does not account for silent myocardial ischaemia; leaves open alternative mechanisms.
Structured PICO
Does baroreceptor stimulation differentially affect pain thresholds in patients with symptomatic versus silent myocardial ischaemia?
P
Population
19 patients with coronary heart disease (9 symptomatic and 10 asymptomatic) underwent experimental baroreceptor manipulation to assess differences in pain sensitivity.
I
Intervention
PRES (phase related external suction) carotid baroreceptor manipulation (negative pressure applied during systole or diastole)
C
Comparator
Symptomatic vs asymptomatic patients; comparison of pain thresholds during different phases of the cardiac cycle
O
Outcome
Sensory detection and electrical pain thresholds during baroreceptor manipulation, and tourniquet pain thresholdspatient reported
Main Result
Effect estimate: F=37.8
p-value: p=<0.001
Baroreceptor-dependent pain inhibition does not explain the higher ischaemic pain thresholds observed in patients with silent myocardial ischaemia.
Limitations
- Respiration was not controlled
- Heterogeneity of medication
- Heterogeneity of degree of vessel disease
Cite This Study
Kardos et al. (1994) studied Symptomatic and silent myocardial ischaemia (n=19). PRES (phase related external suction) carotid baroreceptor manipulation vs. Minimum baroreceptor activity condition was evaluated on Ratings of painful electrical stimuli (F=37.8, p=<0.001). PRES carotid baroreceptor manipulation significantly reduced the perceived intensity of painful electrical stimuli during maximum baroreceptor activity compared to minimum activity (p<0.001), with no difference between symptomatic and asymptomatic myocardial ischaemia patients.