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. 1986 May;41(5):372–375. doi: 10.1136/thx.41.5.372

Are cardiovascular reflexes more commonly impaired in patients with bronchial carcinoma?

G A Gould, M Ashworth, G T Lewis
PMCID: PMC1020630  PMID: 3750244

Abstract

Non-invasive tests of cardiovascular autonomic function were performed in 69 patients with histologically proved bronchial carcinoma and the results compared with those obtained in a group of age and sex matched controls. Only two patients were under 50 years of age, and with the exception of the heart rate response to deep breathing the tests performed have no accepted normal ranges in patients of this age. None of the patients had features of florid, disabling autonomic neuropathy. All the tests of autonomic function showed declining performance with age but in addition there were significant differences in the results when the two groups were compared. In the group with carcinoma the resting heart rate was higher (p less than 0.05), the resting supine blood pressure lower (p less than 0.01), and the postural fall in blood pressure greater (p less than 0.01). Test results were not related to tumour histology, the presence of finger clubbing, drug history, or symptoms suggestive of autonomic dysfunction. Abnormal responses in tests of cardiovascular autonomic function are commonly found in elderly patients but bronchial carcinoma appears to have an additional effect. The precise mechanism of this effect remains a matter for speculation.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Ahmed M. N., Carpenter S. Autonomic neuropathy and carcinoma of the lung. Can Med Assoc J. 1975 Sep 6;113(5):410–412. [PMC free article] [PubMed] [Google Scholar]
  2. Allan T. N., Willson R. A., Lee M. Bronchial carcinoma with autovagotomy and bezoar formation. JAMA. 1977 Jan 24;237(4):364–365. [PubMed] [Google Scholar]
  3. Baldwa V. S., Ewing D. J. Heart rate response to Valsalva manoeuvre. Reproducibility in normals, and relation to variation in resting heart rate in diabetics. Br Heart J. 1977 Jun;39(6):641–644. doi: 10.1136/hrt.39.6.641. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Caird F. I., Andrews G. R., Kennedy R. D. Effect of posture on blood pressure in the elderly. Br Heart J. 1973 May;35(5):527–530. doi: 10.1136/hrt.35.5.527. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Carr-Locke D. L. Autonomic neuropathy and inappropriate secretion of antidiuretic hormone. Occurrence in a patient with bronchogenic carcinoma. JAMA. 1979 May 25;241(21):2298–2298. [PubMed] [Google Scholar]
  6. Collins K. J., Exton-Smith A. N., James M. H., Oliver D. J. Functional changes in autonomic nervous responses with ageing. Age Ageing. 1980 Feb;9(1):17–24. doi: 10.1093/ageing/9.1.17. [DOI] [PubMed] [Google Scholar]
  7. Croft P. B., Wilkinson M. The incidence of carcinomatous neuromyopathy in patients with various types of carcinoma. Brain. 1965 Sep;88(3):427–434. doi: 10.1093/brain/88.3.427. [DOI] [PubMed] [Google Scholar]
  8. Cudkowicz L. Normal, pharmacological and disordered systemic circulatory responses to the Valsalva manoeuvre. Respiration. 1968;25(2):81–115. doi: 10.1159/000192555. [DOI] [PubMed] [Google Scholar]
  9. Dayan A. D., Croft P. B., Wilkinson M. Association of carcinomatous neuromyopathy with different histological types of carcinoma of the lung. Brain. 1965 Sep;88(3):435–448. doi: 10.1093/brain/88.3.435. [DOI] [PubMed] [Google Scholar]
  10. Ewing D. J., Campbell I. W., Murray A., Neilson J. M., Clarke B. F. Immediate heart-rate response to standing: simple test for autonomic neuropathy in diabetes. Br Med J. 1978 Jan 21;1(6106):145–147. doi: 10.1136/bmj.1.6106.145. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Ewing D. J., Clarke B. F. Diagnosis and management of diabetic autonomic neuropathy. Br Med J (Clin Res Ed) 1982 Oct 2;285(6346):916–918. doi: 10.1136/bmj.285.6346.916. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Hines S., Houston M., Robertson D. The clinical spectrum of autonomic dysfunction. Am J Med. 1981 May;70(5):1091–1096. doi: 10.1016/0002-9343(81)90878-0. [DOI] [PubMed] [Google Scholar]
  13. IVY H. K. Renal sodium loss and bronchogenic carcinoma. Associated autonomic neuropathy. Arch Intern Med. 1961 Jul;108:47–55. doi: 10.1001/archinte.1961.03620070049007. [DOI] [PubMed] [Google Scholar]
  14. JOHNSON R. H., SMITH A. C., SPALDING J. M., WOLLNER L. EFFECT OF POSTURE ON BLOOD- PRESSURE IN ELDERLY PATIENTS. Lancet. 1965 Apr 3;1(7388):731–733. doi: 10.1016/s0140-6736(65)92090-8. [DOI] [PubMed] [Google Scholar]
  15. Kirks D. R., Szemes G. C. Autovagotomy and gastric bezoar. A case report. Gastroenterology. 1971 Jul;61(1):96–98. [PubMed] [Google Scholar]
  16. Levin A. B. A simple test of cardiac function based upon the heart rate changes induced by the Valsalva maneuver. Am J Cardiol. 1966 Jul;18(1):90–99. doi: 10.1016/0002-9149(66)90200-1. [DOI] [PubMed] [Google Scholar]
  17. Park D. M., Johnson R. H., Crean G. P., Robinson J. F. Orthostatic hypotension in bronchial carcinoma. Br Med J. 1972 Aug 26;3(5825):510–511. doi: 10.1136/bmj.3.5825.510. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Quinlan C. D. Autonomic neuropathy in carcinoma of the lung. J Ir Med Assoc. 1971 Sep;64(418):430–431. [PubMed] [Google Scholar]
  19. SIEMSEN J. K., MEISTER L. Bronchogenic carcinoma associated with severe orthostatic hypotension. Ann Intern Med. 1963 Apr;58:669–676. doi: 10.7326/0003-4819-58-4-669. [DOI] [PubMed] [Google Scholar]
  20. Smith S. A. Reduced sinus arrhythmia in diabetic autonomic neuropathy: diagnostic value of an age-related normal range. Br Med J (Clin Res Ed) 1982 Dec 4;285(6355):1599–1601. doi: 10.1136/bmj.285.6355.1599. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Smith S. E., Smith S. A. Heart rate variability in healthy subjects measured with a bedside computer-based technique. Clin Sci (Lond) 1981 Oct;61(4):379–383. doi: 10.1042/cs0610379. [DOI] [PubMed] [Google Scholar]
  22. Thomas W. E., Fletcher M. S. Neoplastic autovagotomy causing gastric stasis. Postgrad Med J. 1979 Jun;55(644):411–415. doi: 10.1136/pgmj.55.644.411. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Vargas E., Lye M. The assessment of autonomic function in the elderly. Age Ageing. 1980 Nov;9(4):210–214. doi: 10.1093/ageing/9.4.210. [DOI] [PubMed] [Google Scholar]
  24. Vasudevan C. P., Suppiah P., Udoshi M. B., Lusins J. Reversible autonomic neuropathy and hypertrophic osteoarthropathy in a patient with bronchogenic carcinoma. Chest. 1981 Apr;79(4):479–481. doi: 10.1378/chest.79.4.479. [DOI] [PubMed] [Google Scholar]

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