{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T10:48:45Z","timestamp":1785235725501,"version":"3.55.0"},"reference-count":55,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2000,7]]},"abstract":"<jats:p>\n            <jats:italic>Background and Purpose<\/jats:italic>\n            \u2014Patients with orthostatic hypotension due to sympathetic failure become symptomatic when standing, although their capability to maintain cerebral blood flow is reported to be preserved. We tested the hypothesis that in patients with sympathetic failure, orthostatic symptoms reflect reduced cerebral perfusion with insufficient oxygen supply.\n          <\/jats:p>\n          <jats:p>\n            <jats:italic>Methods<\/jats:italic>\n            \u2014This study addressed the relationship between orthostatic tolerance, mean cerebral artery blood velocity (V\n            <jats:sub>mean<\/jats:sub>\n            , determined by transcranial Doppler ultrasonography), oxygenation (oxyhemoglobin [O\n            <jats:sub>2<\/jats:sub>\n            Hb], determined by near-infrared spectroscopy), and mean arterial pressure at brain level (MAP\n            <jats:sub>MCA<\/jats:sub>\n            , determined by finger arterial pressure monitoring [Finapres]) in 9 patients (aged 37 to 70 years; 4 women) and their age- and sex-matched controls during 5 minutes of standing.\n          <\/jats:p>\n          <jats:p>\n            <jats:italic>Results<\/jats:italic>\n            \u2014Supine MAP\n            <jats:sub>MCA<\/jats:sub>\n            (108\u00b114 versus 86\u00b114 mm Hg) and V\n            <jats:sub>mean<\/jats:sub>\n            (84\u00b121 versus 62\u00b113 cm \u00b7 s\n            <jats:sup>\u22121<\/jats:sup>\n            ) were higher in the patients. After 5 minutes of standing, MAP\n            <jats:sub>MCA<\/jats:sub>\n            was lower in the patients (31\u00b114 versus 72\u00b114 mm Hg), as was V\n            <jats:sub>mean<\/jats:sub>\n            (51\u00b18 versus 59\u00b19 cm \u00b7 s\n            <jats:sup>\u22121<\/jats:sup>\n            ), with a larger reduction in O\n            <jats:sub>2<\/jats:sub>\n            Hb (\u221211.6\u00b14 versus \u22126.7\u00b14.5 \u03bcmol \u00b7 L\n            <jats:sup>\u22121<\/jats:sup>\n            ). Four patients terminated standing after 1 to 3.5 minutes. In these symptomatic patients, the orthostatic fall in V\n            <jats:sub>mean<\/jats:sub>\n            was greater (45\u00b16 versus 64\u00b110 cm \u00b7 s\n            <jats:sup>\u22121<\/jats:sup>\n            ), and the orthostatic decrease in O\n            <jats:sub>2<\/jats:sub>\n            Hb (\u221212.0\u00b13.3 versus \u22127.6\u00b13.9 \u03bcmol \u00b7 L\n            <jats:sup>\u22121<\/jats:sup>\n            ) tended to be larger. The reduction in MAP\n            <jats:sub>MCA<\/jats:sub>\n            was larger after 10 seconds of standing, and MAP\n            <jats:sub>MCA<\/jats:sub>\n            was lower after 1 minute (25\u00b18 versus 40\u00b16 mm Hg).\n          <\/jats:p>\n          <jats:p>\n            <jats:italic>Conclusions<\/jats:italic>\n            \u2014In patients with sympathetic failure, the orthostatic reduction in cerebral blood velocity and oxygenation is larger. Patients who become symptomatic within 5 minutes of standing are characterized by a pronounced orthostatic fall in blood pressure, cerebral blood velocity, and oxygenation manifest within the first 10 seconds of standing.\n          <\/jats:p>","DOI":"10.1161\/01.str.31.7.1608","type":"journal-article","created":{"date-parts":[[2011,6,17]],"date-time":"2011-06-17T20:10:52Z","timestamp":1308341452000},"page":"1608-1614","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":104,"title":["Orthostatic Tolerance, Cerebral Oxygenation, and Blood Velocity in Humans With Sympathetic Failure"],"prefix":"10.1161","volume":"31","author":[{"given":"M.P.M.","family":"Harms","sequence":"first","affiliation":[{"name":"From the Department of Internal Medicine, Academic Medical Center Amsterdam (M.P.M.H., W.W., J.J. van L.); Cardiovascular Research Institute, Amsterdam (M.P.M.H., W.W., J.J. van L.); Departments of Physiology (W.N.J.M.C.) and Internal Medicine (J.W.M.L.), University Hospital Nijmegen; and Department of Anesthesia, Copenhagen Muscle Research Center, Rigshospitalet, Copenhagen (N.H.S.), Denmark."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W.N.J.M.","family":"Colier","sequence":"additional","affiliation":[{"name":"From the Department of Internal Medicine, Academic Medical Center Amsterdam (M.P.M.H., W.W., J.J. van L.); Cardiovascular Research Institute, Amsterdam (M.P.M.H., W.W., J.J. van L.); Departments of Physiology (W.N.J.M.C.) and Internal Medicine (J.W.M.L.), University Hospital Nijmegen; and Department of Anesthesia, Copenhagen Muscle Research Center, Rigshospitalet, Copenhagen (N.H.S.), Denmark."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W.","family":"Wieling","sequence":"additional","affiliation":[{"name":"From the Department of Internal Medicine, Academic Medical Center Amsterdam (M.P.M.H., W.W., J.J. van L.); Cardiovascular Research Institute, Amsterdam (M.P.M.H., W.W., J.J. van L.); Departments of Physiology (W.N.J.M.C.) and Internal Medicine (J.W.M.L.), University Hospital Nijmegen; and Department of Anesthesia, Copenhagen Muscle Research Center, Rigshospitalet, Copenhagen (N.H.S.), Denmark."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.W.M.","family":"Lenders","sequence":"additional","affiliation":[{"name":"From the Department of Internal Medicine, Academic Medical Center Amsterdam (M.P.M.H., W.W., J.J. van L.); Cardiovascular Research Institute, Amsterdam (M.P.M.H., W.W., J.J. van L.); Departments of Physiology (W.N.J.M.C.) and Internal Medicine (J.W.M.L.), University Hospital Nijmegen; and Department of Anesthesia, Copenhagen Muscle Research Center, Rigshospitalet, Copenhagen (N.H.S.), Denmark."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.H.","family":"Secher","sequence":"additional","affiliation":[{"name":"From the Department of Internal Medicine, Academic Medical Center Amsterdam (M.P.M.H., W.W., J.J. van L.); Cardiovascular Research Institute, Amsterdam (M.P.M.H., W.W., J.J. van L.); Departments of Physiology (W.N.J.M.C.) and Internal Medicine (J.W.M.L.), University Hospital Nijmegen; and Department of Anesthesia, Copenhagen Muscle Research Center, Rigshospitalet, Copenhagen (N.H.S.), Denmark."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.J.","family":"van Lieshout","sequence":"additional","affiliation":[{"name":"From the Department of Internal Medicine, Academic Medical Center Amsterdam (M.P.M.H., W.W., J.J. van L.); Cardiovascular Research Institute, Amsterdam (M.P.M.H., W.W., J.J. van L.); Departments of Physiology (W.N.J.M.C.) and Internal Medicine (J.W.M.L.), University Hospital Nijmegen; and Department of Anesthesia, Copenhagen Muscle Research Center, Rigshospitalet, Copenhagen (N.H.S.), Denmark."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_1_2","unstructured":"Bradbury S Eggleston C. Postural hypotension: report of 3 cases. Am Heart J. 1925;264\u2013266."},{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.0954-6820.1962.tb07201.x"},{"key":"e_1_3_2_3_2","unstructured":"Mathias CJ. Orthostatic hypotension: causes mechanisms and influencing factors. Neurology. 1995;45(suppl 5):S6\u2013S11."},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/0022-510X(80)90127-6"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF00314378"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.52.8.962"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/str.28.9.1677"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/73.4.503"},{"key":"e_1_3_2_9_2","first-page":"1075","volume":"58","year":"1987","unstructured":"Glaister DH, Lenox JB. The effect of head and neck suction on G tolerance. Aviat Space Environ Med. 1987;58:1075\u20131081.","journal-title":"Aviat Space Environ Med"},{"key":"e_1_3_2_10_2","first-page":"99","volume":"61","year":"1990","unstructured":"Glaister DH, Miller NL. Cerebral tissue oxygen status and psychomotor performance during lower body negative pressure (LBNP). Aviat Space Environ Med. 1990;61:99\u2013105.","journal-title":"Aviat Space Environ Med"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.46.5.1470"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2281.1997.01414.x"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0301-0082(98)00093-8"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1088\/0031-9155\/33\/12\/008"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/0005-2728(88)90069-2"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-4615-3404-4_17"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1203\/00006450-199301000-00012"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.1800810911"},{"key":"e_1_3_2_19_2","first-page":"769","volume":"57","year":"1982","unstructured":"Aaslid R, Markwalder TM, Nornes H. Noninvasive transcranial Doppler ultrasound recording of flow velocity in basal cerebral arteries. J Neurol. 1982;57:769\u2013774.","journal-title":"J Neurol"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1038\/jcbfm.1991.171"},{"key":"e_1_3_2_21_2","first-page":"67","volume":"36","year":"1995","unstructured":"Wesseling KH, De Wit B, Van der Hoeven GMA, Van Goudoever J, Settels JJ. Physiocal, calibrating finger vascular physiology for Finapres. Homeostasis. 1995;36:67\u201382.","journal-title":"Homeostasis"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-6576.1990.tb03137.x"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1042\/cs0910193"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.eurheartj.a060790"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1152\/jappl.1993.74.5.2566"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-199905000-00016"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1042\/cs0970291"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF02330482"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-6576.1995.tb04110.x"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.1161\/str.28.9.1686"},{"key":"e_1_3_2_31_2","unstructured":"Bevington PR. Data Reduction and Error Analysis for the Physical Sciences. New York NY: McGraw-Hill Book Co; 1969."},{"key":"e_1_3_2_32_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.90.1.8026012"},{"key":"e_1_3_2_33_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.84.3.1884446"},{"key":"e_1_3_2_34_2","doi-asserted-by":"publisher","DOI":"10.1161\/str.28.9.1677"},{"key":"e_1_3_2_35_2","doi-asserted-by":"publisher","DOI":"10.1161\/str.29.1.104"},{"key":"e_1_3_2_36_2","doi-asserted-by":"publisher","DOI":"10.1227\/00006123-199305000-00006"},{"key":"e_1_3_2_37_2","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1986.65.5.0636"},{"key":"e_1_3_2_38_2","doi-asserted-by":"publisher","DOI":"10.1136\/adc.71.2.103"},{"key":"e_1_3_2_39_2","unstructured":"Mchedlishvili G. Cerebral arterial behavior providing constant cerebral bloodflow pressure and volume. In: Bevan JA ed. Arterial Behavior and Blood Circulation in the Brain. New York NY: Plenum Press; 1986:42\u201395."},{"key":"e_1_3_2_40_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-201X.1998.0308f.x"},{"key":"e_1_3_2_41_2","first-page":"99","volume":"61","year":"1990","unstructured":"Glaister DH, Miller NL. Cerebral tissue oxygen status and psychomotor performance during lower body negative pressure (LBNP). Aviat Space Environ Med. 1990;61:99\u2013105.","journal-title":"Aviat Space Environ Med"},{"key":"e_1_3_2_42_2","doi-asserted-by":"publisher","DOI":"10.1097\/00008506-199610000-00004"},{"key":"e_1_3_2_43_2","first-page":"199","volume":"59","year":"1988","unstructured":"Glaister DH, Jobsis-VanderVliet FF. A near-infrared spectrophotometric method for studying brain O2 sufficiency in man during +Gz acceleration. Aviat Space Environ Med. 1988;59:199\u2013207.","journal-title":"Aviat Space Environ Med"},{"key":"e_1_3_2_44_2","doi-asserted-by":"publisher","DOI":"10.1161\/str.19.8.3135641"},{"key":"e_1_3_2_45_2","doi-asserted-by":"publisher","DOI":"10.1161\/res.9.5.1089"},{"key":"e_1_3_2_46_2","doi-asserted-by":"publisher","DOI":"10.1161\/str.28.6.1195"},{"key":"e_1_3_2_47_2","unstructured":"Wieling W Van Lieshout JJ. Maintenance of postural normotension in humans. In: Low PA ed. Clinical Autonomic Disorders. 2nd ed. Boston Mass: Little Brown & Co; 1997:73\u201382."},{"key":"e_1_3_2_48_2","doi-asserted-by":"crossref","first-page":"2C","DOI":"10.1016\/0002-9149(89)90396-2","volume":"63","year":"1989","unstructured":"Paulson OB, Waldemar G, Schmidt JF, Strandgaard S. Cerebral circulation under normal and pathologic conditions. Am J Cardiol. 1989;63:2C\u20135C.","journal-title":"Am J Cardiol"},{"key":"e_1_3_2_49_2","unstructured":"Wilcox CS. Body fluids and renal function in autonomic failure. In: Bannister R ed. Autonomic Failure: A Textbook of Clinical Disorders of the Autonomic Nervous System. Oxford England: Oxford University Press; 1985:115\u2013154."},{"key":"e_1_3_2_50_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF02291388"},{"key":"e_1_3_2_51_2","first-page":"72","volume":"39","year":"1991","unstructured":"Van Lieshout JJ, Ten Harkel ADJ, Van Leeuwen AM, Wieling W. Contrasting effects of acute and chronic volume expansion on orthostatic blood pressure control in a patient with autonomic circulatory failure. Neth J Med. 1991;39:72\u201383.","journal-title":"Neth J Med"},{"key":"e_1_3_2_52_2","unstructured":"DiBona GF Wilcox CS. The kidney and the sympathetic nervous system. In: Bannister R Mathias CJ eds. Autonomic Failure. 3rd ed. Oxford England: Oxford University Press; 1992:178\u2013196."},{"key":"e_1_3_2_53_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(74)90029-0"},{"key":"e_1_3_2_54_2","first-page":"331","volume":"104","year":"1984","unstructured":"Wilcox CS, Puritz R, Lightman SL, Bannister R, Aminoff MJ. Plasma volume regulation in patients with progressive autonomic failure during changes in salt intake or posture. J Lab Clin Med. 1984;104:331\u2013339.","journal-title":"J Lab Clin Med"},{"key":"e_1_3_2_55_2","unstructured":"Robertson D Davis TL. Recent advances in the treatment of orthostatic hypotension. Neurology. 1995;45(suppl 5):S26\u2013S32."}],"container-title":["Stroke"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/01.STR.31.7.1608","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,12]],"date-time":"2024-05-12T22:34:49Z","timestamp":1715553289000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/01.STR.31.7.1608"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2000,7]]},"references-count":55,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2000,7]]}},"alternative-id":["10.1161\/01.STR.31.7.1608"],"URL":"https:\/\/doi.org\/10.1161\/01.str.31.7.1608","relation":{},"ISSN":["0039-2499","1524-4628"],"issn-type":[{"value":"0039-2499","type":"print"},{"value":"1524-4628","type":"electronic"}],"subject":[],"published":{"date-parts":[[2000,7]]},"assertion":[{"value":"2000-01-31","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2000-04-12","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2000-07-01","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}