Published in:
08-09-2022 | Hypotension | Research Article
Utricular dysfunction in patients with orthostatic hypotension
Authors:
Jae-Gyum Kim, Jeong-Heon Lee, Sun-Uk Lee, Jeong-Yoon Choi, Byung-Jo Kim, Ji-Soo Kim
Published in:
Clinical Autonomic Research
|
Issue 6/2022
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Abstract
Purpose
To delineate the association between otolithic dysfunction and orthostatic hypotension (OH).
Methods
We retrospectively reviewed the medical records of 382 patients who presented with orthostatic dizziness at a tertiary dizziness center between July 2017 and December 2021. Patients were included for analyses when they had completed ocular (oVEMP) and/or cervical vestibular-evoked myogenic potentials (cVEMP), and head-up tilt table test with a Finometer (n = 155). We compared the results between the patients with OH (n = 38) and those with NOI (normal head-up tilt table test despite orthostatic intolerance, n = 117).
Results
Thirty-eight patients with OH were further categorized as either classic (n = 30), delayed (n = 7), or initial (n = 1) types. Multivariable logistic regression showed that OH was associated with high baseline systolic BP (p = 0.046), presence of heart failure (p = 0.016), and unilateral oVEMP abnormalities (p = 0.016). n1 latency of oVEMP were negatively correlated with the maximal changes of systolic blood pressure (BP) in 15 s (\(\Delta \)SBP15s, p = 0.013), 3 min (\(\Delta \)SBP3min, p = 0.005) and 10 min (\(\Delta \)SBP10min, p = 0.002). In contrast, the n1-p1 amplitude was positively correlated with \(\Delta \)SBP15s (p = 0.029). Meanwhile, p13 latency of cVEMP was negatively correlated with \(\Delta \)SBP10min (p = 0.018).
Conclusions
Our study provides evidence of utricular dysfunction related to OH.