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Heart rate and blood pressure effects during caloric vestibular testing

Published online by Cambridge University Press:  19 March 2010

A V Kasbekar*
Affiliation:
Department of Otolaryngology, Cambridge University Hospitals NHS Foundation Trust, UK
D M Baguley
Affiliation:
Department of Audiology, Cambridge University Hospitals NHS Foundation Trust, UK
R Knight
Affiliation:
Department of Audiology, Cambridge University Hospitals NHS Foundation Trust, UK
P Gomersall
Affiliation:
Department of Audiology, Cambridge University Hospitals NHS Foundation Trust, UK
R Parker
Affiliation:
Centre for Applied Medical Statistics, University of Cambridge, UK
S W K Lloyd
Affiliation:
Department of Otolaryngology, Cambridge University Hospitals NHS Foundation Trust, UK
K Butler
Affiliation:
Department of Audiology, Cambridge University Hospitals NHS Foundation Trust, UK
D P Dutka
Affiliation:
Department of Cardiology, Cambridge University Hospitals NHS Foundation Trust, UK
*
Address for correspondence: Mr Anand Kasbekar, Flat 2/2, 67 Wilton Street, Glasgow G20 6RD, Scotland, UK. E-mail: anandkasbekar@doctors.org.uk

Abstract

Objectives:

To determine whether the caloric vestibular test causes significant changes in heart rate and mean arterial blood pressure.

Materials and methods:

Changes in heart rate and mean arterial blood pressure before and after caloric irrigation were compared with the degree of nystagmus (as measured by maximum slow phase velocity) and the patient's subjective dizziness (scored from 0 to 10). A cardiologist reviewed each patient's heart rate and mean arterial blood pressure changes. Patients' anxiety levels were also assessed.

Results:

Eighteen patients were recruited. There were no adverse events in any patient. There were no overall significant differences between the heart rate and mean arterial pressure before and after each irrigation. There was a significant correlation between the maximum slow phase velocity and patients' subjective dizziness scores.

Conclusion:

Heart rate and mean arterial blood pressure are not significantly influenced by the caloric vestibular test. This preliminary study will enable patients with stable cardiovascular disease to be recruited for further risk determination.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2010

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Footnotes

The first two authors contributed equally to this paper, and should be considered as joint first authors.

Presented at the British Academy of Audiology Conference, 28 November 2009, Liverpool, UK.

References

1 Barany, R. Investigations into the rhythm of the vestibular apparatus of ear reflex induced nystagmus and its concomitants [in German]. Monatsschr F Ohrenheilk 1906;4:193297Google Scholar
2 British Society of Audiology. Caloric test protocol. Br J Audiol 1999;33:179–84Google Scholar
3 Eviatar, A. Severe bradycardia induced by caloric test in cardiac patients. Ann Otol Rhinol Laryngol 1970;79:680–4Google Scholar
4 Ray, CA, Carter, JR. Vestibular activation of sympathetic nerve activity. Acta Physiol Scand 2003;177:313–19Google Scholar
5 Carter, JR, Ray, CA. Sympathetic responses to vestibular activation in humans. Am J Physiol Regul Integr Comp Physiol 2008;294:681–8Google Scholar
6 Ray, CA, Hume, KM, Steele, SL. Sympathetic nerve activity during natural stimulation of horizontal semicircular canals in humans. Am J Physiol 1998;275:1274–8Google ScholarPubMed
7 Yates, BJ, Miller, AD. Properties of sympathetic reflexes elicited by natural vestibular stimulation: implications for cardiovascular control. J Neurophysiol 1994;71:2087–92CrossRefGoogle ScholarPubMed
8 Monahan, KD, Ray, CA. Vestibulosympathetic reflex during orthostatic challenge in aging humans. Am J Physiol Regul Integr Comp Physiol 2002;283:1027–32CrossRefGoogle ScholarPubMed
9 Costa, F, Lavin, P, Robertson, D, Biaggioni, I. Effect of neurovestibular stimulation on autonomic regulation. Clin Auton Res 1995;5:289–93Google Scholar
10 Jauregui-Renaud, K, Yarrow, K, Oliver, R, Gresty, MA, Bronstein, AM. Effects of caloric stimulation on respiratory frequency and heart rate and blood pressure variability. Brain Res Bull 2000;53:1723Google Scholar
11 Spielberger, CD. Manual for the State-Trait Anxiety Inventory STAI (Form Y). Palo Alto, California: Consulting Psychologists Press, 1983Google Scholar
12 Jongkees, LB, Maas, JP, Philipszoon, AJ. Clinical nystagmography. A detailed study of electro-nystagmography in 341 patients with vertigo. Pract Otorhinolaryngol 1962;24:6593Google ScholarPubMed
13 Ray, CA, Monahan, KD. Aging attenuates the vestibulosympathetic reflex in humans. Circulation 2002;105:956–61Google Scholar
14 Wilson, TE, Kuipers, NT, McHugh, EA, Ray, CA. Vestibular activation does not influence skin sympathetic nerve responses during whole body heating. J Appl Physiol 2004;97:540–4CrossRefGoogle ScholarPubMed
15 Cui, J, Mukai, C, Iwase, S, Sawasaki, N, Kitazawa, H, Mano, T et al. Response to vestibular stimulation of sympathetic outflow to muscle in humans. J Auton Nerv Syst 1997;66:154–62Google Scholar
16 Cui, J, Iwase, S, Mano, T, Kitazawa, H. Responses of sympathetic outflow to skin during caloric stimulation in humans. Am J Physiol 1999;276:738–44Google Scholar