Autonomic Profile of Patients with Primary Autonomic Failure
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Primary autonomic failure (PAF) is an entity of dysautonomie characterized by the occurrence of severe orthostatic hypotension asympaticotonic often refractory to medical treatment, affecting quality of life . The aim of study is to discribe the autonomic profile of patient with primary autonomic failure. It’s a retrospective study including 125 patients admitted for primary autonomic failure at the diagnosis and treatment center for autonomic dysregulation in cardiology department A of Ibn Sina University Hospital in Rabat. All of them had clinical examination, electrocardiogram, biological exam and autonomic nervous system tests. The mean age of the population was 50.1 ± 14.4 years, with 64% women. The mean baseline HR was 66.6 ± 14.82 bpm. The mean baseline systolic BP (SBP) was 124.77 ± 21.62 mmHg and the average diastolic BP (DBP) was 72.26 ±19 mmHg. The perturbation of the vagal response to DB is found in 70.4% of patients with deficiency in 40% of the cases. The perturbation of the vagal response to HG was found in 76.8% of patients with deficiency in 59% of the cases. The disruption of the peripheral sympathetic response alpha ( alpha SP) to HG was found in 69.6% of patients with deficiency in 54.4% of patients.The disturbance of the central sympathetic response alpha (alpha SC) to MS was found in 71.2% of patients with deficiency in 62.88% of patients . The disturbance of the central sympathetic response beta (beta SC) to MS was found in 69.6% of patients with deficiency in 52% of the cases. The perturbation of the vagal response to tilt test is found in 82.4% of patients with deficiency in 70% of the cases without reflex tachycardia, confirming the neurogenic origin of orthostatic hypotension. Cardiovascular autonomic tests demonstrate the autonomic nervous system failure in this pathology whose major symptom is asympaticotonic orthostatic hypotension.
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