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Neurocardiogenic syncope: the physiopathologic mechanisms of its occurence,diagnosis and treatment


Author: Răducan Aurica
Degree:doctor of medicine
Speciality: 14.00.06 - Cardiology and Rheumatology
Year:2010
Scientific adviser: Aurel Grosu
doctor habilitat, professor, Public Medico-Sanitary Institution Moldavian Institute of Cardiology
Institution: Public Medico-Sanitary Institution Moldavian Institute of Cardiology
Scientific council: D 51-14.00.06
Public Medico-Sanitary Institution Moldavian Institute of Cardiology

Status

The thesis was presented on the 17 December, 2009
Approved by NCAA on the 11 February, 2010

Abstract

Adobe PDF document0.20 Mb / in romanian

Keywords

sincope, pathophysiology, tilt table testing, treatment

Summary

The theses consists of 144 pages, which begins with an introduction, followed by 4 chapters, conclusions, practical recommendations, bibliography from 176 sources, 9 annexe, 16 tables and 18 figures. The obtained results are published in the 13 scientific works.

Domain of research: cardiology.

Goal of research: Elucidation of some physiopathologic mechanisms in neurocardiogenic syncope and improvement of methods of diagnosis and treatment.

Objectives of research: To study the possibility of enhancing the diagnostic value of the tilt table testing and the implication of both nitric oxide and catechilamines in the vasodilation mediation in patients with either neurocardiogenic syncope or syncope with unidentified genesis. To analyse the efficiency of the treatment based on such drugs as propranolol and fluoxetin, administered to patients with neurocardiogenic syncope. To survey the importance of the serumal concentration of the adrenaline during syncope in order to establish the efficiency of the treatment with propranolol.

Methodology of research: Within the framework of the research the following methods have been used: investigation, tilt table testing, laboratory analysis, statistical, monitoring. Novelty and originality of research:It is the first clinical study which has appreciated the serumal fluctuation of the nitric oxide concentration in patients with marked neurocardiogenic syncope and syncope with unidentified genesis, reccuring during the tilt table testing. There has been studied the possibility of increasing the diagnostic value of the test through a successive carrying on of different variants of this diagnostic method.

Theoretical value and applied value: The involvement of catecholamines and nitric oxide in the occurrence of neurally mediated syncope has been confirmed. It has been established that it is unreasonable to use the tilt table testing in assessing the efficiency of the drug-based prolonged treatment in patients with neurocardiogenic syncope.

Practical implementation: The result of the study were estimated as scientific work and later implemented in current curative activity of the Institute of the Cardiology and chair of cardiology of SMPhU ,,Nicolae TestemiŃanu,,.