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Are Compression Stockings an Effective Treatment for Orthostatic Presyncope 英文参考文献
AreCompressionStockingsanEffectiveTreatmentfor
OrthostaticPresyncope?
ClareLouiseProtheroe1,AnastasiaDikareva1,CarloMenon2,VictoriaElizabethClaydon1*
1DepartmentofBiomedicalPhysiologyandKinesiology,SchoolofEngineeringScience,SimonFraserUniversity, BritishColumbia,Canada, 2MenrvaResearchGroup,
SchoolofEngineeringScience,SimonFraserUniversity,BritishColumbia,Canada
Abstract
Background: Syncope, or fainting, affects approximately 6.2% of the population, and is associated with significant
comorbidity.Manysyncopaleventsoccursecondarytoexcessivevenouspoolingandcapillaryfiltrationinthelowerlimbs
whenupright.Assuch,acommonapproachtothemanagementofsyncopeistheuseofcompressionstockings.However,
researchconfirmingtheirefficacyislacking.Weaimedtoinvestigatetheeffectofgradedcalfcompressionstockingson
orthostatictolerance.
Methodology/Principal Findings: We evaluated orthostatic tolerance (OT) and haemodynamic control in 15 healthy
volunteers wearing graded calf compression stockings compared to two placebo stockings in a randomized, cross-over,
double-blindfashion.OT(timetopresyncope,min)wasdeterminedusingcombinedhead-uprighttiltingandlowerbody
negativepressureapplieduntilpresyncope.Throughouttestingwecontinuouslymonitoredbeat-to-beatbloodpressures,
heartrate,strokevolumeandcardiacoutput(fingerplethysmography),cerebralandforearmbloodflowvelocities(Doppler
ultrasound) and breath-by-breath end tidal gases. There were no significant differences in OT between compression
stocking(26.062.3min)andcalf(29.362.4min)orankle(27.663.1min)placeboconditions.Cardiovascular,cerebraland
respiratoryresponsesweresimilarinallconditions.Theefficacyofcompressionstockingswasrelatedtoanthropometric
parameters,andcouldbepredictedbyamodelbasedonthesubject’scalfcircumferenceandshoesize(r=0.780,p=0.004).
Conclusions/Significance: These data question the use of calf compression stockings for orthostatic intolerance and
highlight the need for individualised therapy accounting for anthropometric va
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