{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T09:58:50Z","timestamp":1791194330296,"version":"4.1.0"},"reference-count":27,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2011,11,28]],"date-time":"2011-11-28T00:00:00Z","timestamp":1322438400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2012,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background:<\/jats:title><jats:p>The neurally mediated syncope (NMS) is sustained by complex cardiac and vascular reflexes, acting on and amplified by central autonomic loops, resulting in bradycardia and hypotension.<\/jats:p><\/jats:sec><jats:sec><jats:title>Hypothesis:<\/jats:title><jats:p>Our aim was to assess whether the pathophysiology of NMS is also related to an abnormal peripheral vasoreactivity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods:<\/jats:title><jats:p>We evaluated by ultrasound the flow\u2010mediated vasodilation (FMD) and the nitrate\u2010mediated dilation (NMD) in 17 patients with NMS, induced by drug\u2010free tilt test in 6 subjects and by nitrate\u2010potentiated tilt test in the other 11 cases; the syncope was classified as vasodepressive (VD) in 8 cases, cardioinhibitory (CI) in 7, and mixed in 2.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results:<\/jats:title><jats:p>The FMD was not different from controls (10.2 \u00b1 4.5 vs 11.4 \u00b1 3.9, <jats:italic>P<\/jats:italic> = ns), with normal recovery times; the NMD was greater in fainting subjects than in controls (26.7 \u00b1 7.3 vs 19.0 \u00b1 3.6, <jats:italic>P &lt;<\/jats:italic> 0.05), with higher values in VD than in CI syncope (31.1 \u00b1 7.0 vs 23.1 \u00b1 5.0, <jats:italic>P<\/jats:italic> = ns); compared to controls, subjects with NMS showed normal recovery times after FMD but longer recovery times after nitrate administration (13.0 \u00b1 5.6 vs 6.3 \u00b1 0.7 minutes, <jats:italic>P &lt;<\/jats:italic> 0.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions:<\/jats:title><jats:p>The evaluation of endothelial function supports evidence that NMS is characterized by a marked and sustained endothelial\u2010independent vasodilation, in the presence of a normal FMD; vascular hyperreactivity in response to nitrate administration is particularly overt in vasodepressive syncope and can explain the high rate of responses to nitrate administration during tilt test. \u00a9 2011 Wiley Periodicals, Inc.<\/jats:p><jats:p>The authors have no funding, financial relationships, or conflicts of interest to disclose.<\/jats:p><\/jats:sec>","DOI":"10.1002\/clc.20990","type":"journal-article","created":{"date-parts":[[2011,11,28]],"date-time":"2011-11-28T22:56:47Z","timestamp":1322521007000},"page":"107-110","source":"Crossref","is-referenced-by-count":17,"title":["An Increased Endothelial\u2010Independent Vasodilation Is the Hallmark of the Neurally Mediated Syncope"],"prefix":"10.1002","volume":"35","author":[{"given":"Luca","family":"Santini","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ambrogio","family":"Capria","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentina","family":"Brusca","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arianna","family":"Violo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Smurra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iside","family":"Scarf\u00f2","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni B.","family":"Forleo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lida 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