Abstract
Although some authors have reported clinical features of autonomic dysfunction in patients with malignant disease only a few systematic studies have been carried out. We have investigated the autonomic function of 48 patients with carcinoma or lymphoma by testing their cardiovascular reflexes, and compared their results with those of 62 healthy volunteers. Our patients showed a smaller increase in heart rate and a greater fall in blood pressure on standing up, as well as a smaller rise in blood pressure in response to contralateral handgrip. The study group showed a higher percentage of established sympathetic lesion (54.2% vs 27.4%, p: 0.008) and of atypical pattern of global autonomic function impairment (50% vs 24.2%, p:0.03) than the control group. Our data suggest that patients with malignant disease suffer from a definite autonomic dysfunction.
Sommario
Benché alcuni autori abbiano riportato quadri clinici di disfunzione autonoma in pazienti portatori di tumori maligni, pochi studi sono stati avviati sull'argomento. Noi abbiamo investigato le funzioni autonome in 48 pazienti portatori di carcinoma o di linfoma testando i loro riflessi cardiovascolari e comparando i risultati con quelli ricavati dallo studio di 62 volontari sani. I nostri pazienti documentano un lieve aumento del quoziente cardiaco e una più importante caduta della pressione ortostatica e un contenuto aumento della pressione sanguigna in risposta alla chiusura a pugno controlaterale. Il gruppo studiato dimostra una percentuale di documentata lesione simpatica più alta del normale (54,2% in confronto di 27,4% del normale con p=0.008) e un interessamento globale delle funzioni autonome atipico (50% a confronto del 24,2% del gruppo controllo con p=0.03). I nostri dati, quindi, fanno ritenere che i pazienti portatori di tumori maligni soffronto di una specifica disfunzione autonoma.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Ahmed M. N., Carpenter S.:Autonomic neuropathy and carcinoma of the lung. CMA J, 113:410–412, 1975
Bannister R.:Autonomic failure. Oxford University Press, Oxford, 1983.
Bannister R.:Autonomic failure, 2 ed. Oxford University Press. Oxford, 1989
Chiappa K., Young R. R.:A case of paracarcinomatous pandysautonomia. Neurology, 13:423, 1973.
Ewing D. J.:Practical bedside investigation of diabetic autonomic failure. In: Bannister R., ed.: Autonomic failure. Oxford University Press. Oxford, 371–405, 1983.
Ewing D. J., Clarke B. F.:Diabetic autonomic neuropathy: a clinical viewpoint. In: Dyck P. J. et al. ed., Diabetic Neuropathy. W.B. Saunders Coompany. Philadelphia, 66–68, 1987.
Ewing D. J.,Recent advances in the non-invasive investigation of the diabetic autonomic neuropathy, In.: Bannister R., ed.: Autonomic failure, 2 ed. Oxford University Press, Oxford, 308–320, 1989
Gould G. A., Ashowrth M., Lewis G. T. R.:Are cardiovascular reflexes more commonly impaired in patients with bronchial carcinoma. Thorax, 41:372–375, 1986.
Heidbreder E., Schafferhans K. Heildand A.:Disturbances of peripheral and autonomic nervous system in chronic renal failure: effects of hemodialysis and transplantations. Nephrology, 1985: 23:22–228, 1985 a.
Heidbreder E., Schafferhans K., Heiland A.:Autonomic neuropathy in chronic renal insufficiency. Comparative analysis of diabetic and non diabetic patients. Nephron, 48:50–56, 1985b.
Henson R. A., Urich H.:Cancer and the nervous system. The neurological manifestation of systemic malignant disease Blackwell Scientific Publication. Oxford, 1982
Hilsted J.:Autonomic neuropathy: the diagnosis. Acta Neurol Scand, 67:193–201, 1983
Johnson R. H., Lambie, D. G., Spaldy, J. M. K.:The autonomic Nervous System. In: Baker A. B., Joynt R. J. ed. Clinical Neurology, Vol. 4 (57). Harper & Row Publishers. Philadelphia, 1986.
Park D. M., Johnson R. H., Crean G. P. Robinson J. F.:Orthostatic hypotension with recovery after radiotherapy in a patient with bronchial carcinoma. Br Med J. iii:510–511, 1972.
Thomas J. P., Shiels R.:Associated autonomic dysfunction and carcinoma of the pancreas. Br Med J, iv: 32, 1970
Vita G., Princi P., Calabro R. et al.:Cardiovascular reflex tests: assessment of age-adjusted normal range. J Neurol Sci, 74:263–274, 1986
Walsh J. C., McLeod J. G. Neuropathy associated with lymphoma. J Neurol Neurosurg Psychiatry 34:42–50, 1970
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Martin, R., Delgado, J.M., Moltò, J.M. et al. Cardiovascular reflexes in patients with malignant disease. Ital J Neuro Sci 13, 125–129 (1992). https://doi.org/10.1007/BF02226960
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF02226960