ArticleEuropean heart journal2026
Peripheral autonomic dysregulation in response to standing: a new form associated with cardiovascular disease, mobility reduction, and cognitive alterations.
Article in European heart journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
1 citing paper in PubMed.
- Falling for cardiac output: an enticing new orthostatic phenotype.European heart journal · 2026Article
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12 authors.
Funding
Abstract
BACKGROUND AND
aimsCardiovascular responses to standing are essential for maintaining cerebrovascular blood flow. While orthostatic blood pressure (BP) responses have been studied extensively, the role of cardiac output (CO) remains unclear. This study aimed to investigate patterns of orthostatic CO responses, their physiological determinants, and clinical relevance.
methodsReal-time haemodynamic responses to active standing were recorded in two prospective cohorts: 3074 young (Melbourne) and 3025 older (Ireland) adults. In the young, five subgroups assessed phenotype reproducibility (same-day and two-week retests), responses to vasodilation (sublingual glyceryl trinitrate, GTN) or sympathetic activation (SA; handgrip with phenylephrine), and associations with urinary electrolyte excretion. In older adults, CO patterns were related to clinical characteristics and outcomes.
resultsA reproducible dichotomy in the initial orthostatic CO response was identified: either a transient rise (COR: 66% young, 78% older) or fall (COF: 34% young, 22% older). COF subjects had less heart rate increase and greater transient reductions in stroke volume and BP upon standing, despite an increased sympathetic response. GTN exaggerated COF, whereas SA mitigated it. In older adults, COF was more prevalent with cardiovascular disease, higher body mass index, smoking, diabetes, or antihypertensive use. After adjustment, COF remained associated with slower gait, frailty, and diminished cognitive function (all P < .001). Among subjects on negatively chronotropic drugs (n = 487), falls were more frequent in COF (odds ratio 1.82, 95% confidence interval 1.18-2.80).
conclusionsThese findings reveal a novel variant of the autonomic cardiovascular response to standing, with important clinical implications for functional decline in older adults.
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