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Venous capacitance and venous return in young adults with typical vasovagal syncope: a cross-sectional study
  1. Ely Fish1,
  2. Sapir Barak Lanciano2,
  3. Itay Shavit2,
  4. Hagar Palacci2,
  5. Chen Chaiat2,
  6. Ishay Avivi2,
  7. Ella Haber Kaptsenel2,
  8. Udi Nussinovitch3
  1. 1Department of Psychiatry, Westchester Medical Center, Valhalla, NY, USA
  2. 2Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
  3. 3Division of Cardiovascular Medicine, Stanford University, Palo Alto, CA, USA
  1. Correspondence to Dr Udi Nussinovitch, Division of Cardiovascular Medicine, Stanford University, Palo Alto, CA, USA; udi.nussinovitch{at}gmail.com

Abstract

Vasovagal syncope (VVS) has a high prevalence in the general population and is associated with potential complications. There is limited information on the possible association between venous capacitance (VC) and venous return (VR), important determinants of preload and VVS. Since the tilt test was reported to yield a high rate of false positive results, the aim of this study was to evaluate whether abnormal VC and VR at baseline could predispose individuals to VVS.

To this end, 88 young, healthy volunteers were recruited and classified to 26 (29.5%) who experienced typical VVS and 62 (70.5%) who did not. VC and VR were evaluated with a commercial device and plethysmography applied to the elevated legs. Maximum venous outflow (MVO), segmental venous capacitance (SVC) and MVO/SVC ratio were calculated and averaged.

No significant differences between MVO (5.0±0.5 vs 5.6±0.8, p>0.05), SVC (6.0±0.5 vs 6.3±0.8, p>0.05) or MVO/SVC ratio (0.83±0.02 vs 0.86±0.03, p>0.05) were observed for the non-VVS and VVS volunteers, respectively. There was a significant association between a higher MVO and SVC values and a larger decrease in diastolic blood pressure with standing, although correlations were weak (R2=0.0582 and 0.0681, respectively).

In conclusion, at baseline, VC and VR are not impaired in healthy volunteers with a history of VVS. It remains unknown if similar results would be found in patients with cardiovascular comorbidities. Also, the sensitivity of VC and VR evaluations to identify a predisposition for VVS following physiological provocations merits further study.

  • cardiovascular diseases

Data availability statement

Data are available on reasonable request.

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Data availability statement

Data are available on reasonable request.

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Footnotes

  • Contributors UN designed the study. IA, SBL, IS, EHK, HP and CC performed the experiments and analyzed the data. UN and EJF analyzed and interpreted the data, wrote the manuscript. UN revised the manuscript. All authors approved the submitted version.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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