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Serotonin and vasovagal syncope.

Mohammed Alsaleh1, Aryan Talati1, Satish R Raj1

  • 1Department of Cardiac Sciences, Cumming School of Medicine, Libin Cardiovascular Institute, University of Calgary, GAA04 HRIC Building 3280 Hospital Drive Calgary, Calgary, AB, T2N 4Z6, Canada.

Clinical Autonomic Research : Official Journal of the Clinical Autonomic Research Society
|July 9, 2024
PubMed
Summary
This summary is machine-generated.

Serotonin neurotransmission is implicated in vasovagal syncope. Evidence suggests serotonin 5HT3 receptors and the serotonin reuptake transporter (SERT) play a role in its physiology and treatment.

Keywords:
Bezold-Jarisch reflexClinical trialsSerotoninVasovagal syncope

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Area of Science:

  • Neuroscience
  • Cardiology
  • Pharmacology

Background:

  • Vasovagal syncope is a common condition characterized by a sudden drop in heart rate and blood pressure.
  • The Bezold-Jarisch reflex, triggered by serotonin, has been proposed as a potential mechanism underlying vasovagal syncope.

Purpose of the Study:

  • To review the biological and clinical evidence linking serotonin neurotransmission to the physiology and treatment of vasovagal syncope.

Main Methods:

  • Literature review of PubMed and secondary sources.
  • Focus on the Bezold-Jarisch reflex, serotonin's role, and clinical evidence in vasovagal syncope.

Main Results:

  • Serotonin stimulates cardiac receptors, activating the Bezold-Jarisch reflex, which shares features with vasovagal syncope.
  • Genetic and physiological data support the involvement of serotonin 5HT1A and 5HT3 receptors and SERT.
  • SERT blockade induces syncope; SERT inhibition mitigates syncope symptoms.
  • Clinical trials show SERT inhibitors significantly reduce vasovagal syncope recurrence.

Conclusions:

  • Multiple lines of evidence strongly implicate serotonin neurotransmission in the pathophysiology of vasovagal syncope.
  • Targeting serotonin pathways, particularly SERT, shows promise for vasovagal syncope treatment.