Development Of A Cold Pressor Test Protocol To Evaluate Cardiac Autonomic Function

2005 ◽  
Vol 37 (Supplement) ◽  
pp. S232
Author(s):  
Jennifer L. Wirch ◽  
Larry A. Wolfe ◽  
Tracey L. Weissgerber ◽  
Gregory A. L. Davies
2005 ◽  
Vol 37 (Supplement) ◽  
pp. S232
Author(s):  
Jennifer L. Wirch ◽  
Larry A. Wolfe ◽  
Tracey L. Weissgerber ◽  
Gregory A. L. Davies

2006 ◽  
Vol 31 (3) ◽  
pp. 235-243 ◽  
Author(s):  
Jennifer L Wirch ◽  
Larry A Wolfe ◽  
Tracey L Weissgerber ◽  
Gregory A.L Davies

The primary objective of this study was to develop a cold pressor test (CPT) protocol to evaluate cardiac autonomic function. Secondary objectives were to assess CPT protocol reliability and to examine gender differences in response to orthostatic stress and the CPT. Healthy, normotensive men and women (n = 12 per group) completed 2 trials on different days in the left lateral decubitus and standing postures and during a 6 min CPT (hand immersion while seated). Measurements included R-R interval, blood pressure, ventilatory responses, spontaneous baroreflex sensitivity, and heart rate variability indices. During the CPT, blood pressure and the sympathetic nervous system (SNS) indicator increased significantly and low-frequency power, high-frequency power (normalized for tidal volume), and the parasympathetic nervous system (PNS) indicator decreased significantly. Standing caused significant increases in the SNS indicator and decreases in the R-R interval in both genders. The PNS indicator was higher in women than in men in the left lateral decubitus posture. The 6 min hand-immersion CPT provoked cardiac sympathetic activation and parasympathetic withdrawal; however, it is best suited to studies with a repeated measures design, as analysis of reliability suggests that responses are highly variable between individuals. Performing the CPT in the left lateral decubitus position may prevent vasovagal responses.Key words: cold pressor test, sympathetic nervous system, parasympathetic nervous system, gender, posture.


1981 ◽  
Vol 51 (2) ◽  
pp. 516-519 ◽  
Author(s):  
W. B. Baun ◽  
A. Jackson ◽  
R. W. Patton ◽  
P. B. Raven

The five most used cold pressor test heart rate protocols were compared to the true R-R interval responses recorded during a cold hand test. Forty-one nonsmoking male volunteers between 18 and 55 yr were given a cold hand pressor test. Heart rate was evaluated by averaging the R-R interval within 2-, 5-, 6-, 10-, and 30-s time intervals and by the true R-R interval measurement. No significant physiological differences existed at rest; however, during stress the maximum values obtained were successively diminished the greater the time utilized to average the heart rate pressure (P less than 0.05). During recovery an underestimation of the true response was observed that increased as the averaging time increased (P less than 0.05). Comparison between the R-R interval measure and the 6-s average data indicated a 18% decrease in the time of peak response. Therefore, the responses recorded with the 6-s averaged data were less sensitive and obscured the rapidity of autonomic changes. Hence, when sensitivity and absolute response are a primary concern in determining autonomic function, measurements should include R-R interval measures of heart rate or the average of the number of R-R intervals in 2-s time blocks.


1982 ◽  
Vol 63 (3) ◽  
pp. 285-292 ◽  
Author(s):  
C. Zoccali ◽  
M. Ciccarelli ◽  
Q. Maggiore

1. To localize the site of autonomic abnormality in patients undergoing haemodialysis, tests of overall autonomic function based on either changes in blood pressure (posture, sustained handgrip) or heart rate (Valsalva manoeuvre, 30:15 ratio, deep breathing test) were used. Integrity of the sympathetic efferent arc was examined by using the cold pressor test and the parasympathetic efferent arc by the atropine test. Eighteen patients and 12 control subjects were studied. 2. Changes in blood pressure on standing, sustained handgrip and in the cold pressor test were the same in the two groups. 3. In contrast, 11 patients had abnormal results in at least two of the three heart-rate-based tests. 4. Three of the 11 dialysis patients with evidence of autonomic involvement showed abnormal responses to atropine, indicating an efferent parasympathetic lesion, whereas the majority had a normal response to the atropine test, suggesting an afferent lesion only. 5. Evidence of autonomic involvement was not associated with hypertension nor confined to patients with dialysis hypotension.


2016 ◽  
Vol 14 (4) ◽  
Author(s):  
Marcelo Coertjens

Introdução: A crioterapia é um recurso que diminui a temperatura corporal local com finalidades terapêuticas. Uma importante repercussão é a vasoconstrição local, que seria o desencadeador de um possível aumento na pressão arterial (PA). Entretanto, não existem trabalhos que comprovem essa suposição. Nossa hipótese é que os resultados das pesquisas de Cold Pressor Test (CPT) avaliando PA acabaram historicamente fundamentando as precauções da crioterapia em relação a pacientes hipertensos. Objetivo: Realizar uma revisão de literatura a respeito das pesquisas que sustentam a precaução da crioterapia em indivíduos hipertensos e verificar sua relação com estudos que utilizaram o CPT. Material e métodos: Trata-se de uma revisão de literatura que utilizou as bases de dados online Medline, Scielo, Lilacs e Google Acadêmico para a realização da pesquisa. Resultado: Apesar de não serem unânimes, diversas pesquisas que utilizaram o CPT encontraram significativos aumentos da atividade nervosa simpática muscular e da PA em normotensos e hipertensos, entretanto não encontramos estudos que tenham comprovado respostas significativas de PA com o uso da crioterapia, principalmente, em hipertensos. Conclusão: Não existem evidências científicas que comprovem a precaução da crioterapia em indivíduos hipertensos. Além disso, os estudos com CPT não são unânimes em relação aos aumentos pressóricos em indivíduos normotensos e hipertensos.Palavras-chave: crioterapia, hemodinâmica, hipertensão, pressão arterial. 


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