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Mayer wave activity in vasodepressor carotid sinus hypersensitivity.
Ciarán Finucane1, Gerard Boyle, Chie Wei Fan
1Department of Medical Physics and Bioengineering, St James's Hospital, Dublin 8, Ireland. cfinucane@stjames.ie
Summary
Vasodepressor carotid sinus hypersensitivity (VDCSH) is linked to increased blood pressure variability, particularly at Mayer wave frequencies. This finding may aid in diagnosing VDCSH and managing syncope and falls.
Area of Science:
- Cardiovascular Physiology
- Autonomic Nervous System Function
- Geriatric Medicine
Background:
- Mayer waves are low-frequency blood pressure oscillations modulated by baroreflex pathways.
- Vasodepressor carotid sinus hypersensitivity (VDCSH) is a common hypotensive disorder in the elderly, but its underlying mechanisms remain unclear.
- Impaired baroreflex function is hypothesized to contribute to VDCSH, potentially altering Mayer wave characteristics.
Purpose of the Study:
- To investigate the relationship between baroreflex function and Mayer wave activity in individuals with VDCSH.
- To determine if altered Mayer wave amplitude and oscillation frequency are characteristic of VDCSH.
- To explore the potential of blood pressure variability analysis for VDCSH diagnosis.
Main Methods:
- Continuous beat-to-beat blood pressure recordings were obtained during carotid sinus massage in patients with VDCSH and age-matched controls.
- Spectral analysis was used to examine blood pressure variability, focusing on Mayer wave frequencies (0.04-0.15 Hz) and higher frequencies.
- VDCSH was defined by a significant drop in systolic blood pressure during carotid sinus massage.
Main Results:
- Patients with VDCSH exhibited significantly higher diastolic and mean arterial blood pressure variability compared to controls.
- Increased low-frequency Mayer wave activity was observed in VDCSH patients at 0.06 Hz and 0.1 Hz.
- High-frequency blood pressure fluctuations were significantly elevated in the VDCSH group at 0.3 Hz for both systolic and mean arterial blood pressure.
Conclusions:
- Blood pressure variability, especially at Mayer wave frequencies, is significantly increased in individuals with VDCSH.
- These findings suggest that altered blood pressure variability patterns may serve as a diagnostic marker for VDCSH.
- Further research could establish this approach for VDCSH diagnosis, impacting syncope and fall management in the elderly.
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