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Thorax. 1986 May; 41(5): 372–375.
PMCID: PMC1020630

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


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

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  • Dayan AD, Croft PB, Wilkinson M. Association of carcinomatous neuromyopathy with different histological types of carcinoma of the lung. Brain. 1965 Sep;88(3):435–448. [PubMed]
  • Croft PB, Wilkinson M. The incidence of carcinomatous neuromyopathy in patients with various types of carcinoma. Brain. 1965 Sep;88(3):427–434. [PubMed]
  • Kirks DR, Szemes GC. Autovagotomy and gastric bezoar. A case report. Gastroenterology. 1971 Jul;61(1):96–98. [PubMed]
  • Allan TN, Willson RA, Lee M. Bronchial carcinoma with autovagotomy and bezoar formation. JAMA. 1977 Jan 24;237(4):364–365. [PubMed]
  • Thomas WE, Fletcher MS. Neoplastic autovagotomy causing gastric stasis. Postgrad Med J. 1979 Jun;55(644):411–415. [PMC free article] [PubMed]
  • IVY HK. Renal sodium loss and bronchogenic carcinoma. Associated autonomic neuropathy. Arch Intern Med. 1961 Jul;108:47–55. [PubMed]
  • SIEMSEN JK, MEISTER L. Bronchogenic carcinoma associated with severe orthostatic hypotension. Ann Intern Med. 1963 Apr;58:669–676. [PubMed]
  • Park DM, Johnson RH, Crean GP, Robinson JF. Orthostatic hypotension in bronchial carcinoma. Br Med J. 1972 Aug 26;3(5825):510–511. [PMC free article] [PubMed]
  • Ahmed MN, Carpenter S. Autonomic neuropathy and carcinoma of the lung. Can Med Assoc J. 1975 Sep 6;113(5):410–412. [PMC free article] [PubMed]
  • Quinlan CD. Autonomic neuropathy in carcinoma of the lung. J Ir Med Assoc. 1971 Sep;64(418):430–431. [PubMed]
  • Vasudevan CP, Suppiah P, Udoshi MB, Lusins J. Reversible autonomic neuropathy and hypertrophic osteoarthropathy in a patient with bronchogenic carcinoma. Chest. 1981 Apr;79(4):479–481. [PubMed]
  • Carr-Locke DL. Autonomic neuropathy and inappropriate secretion of antidiuretic hormone. Occurrence in a patient with bronchogenic carcinoma. JAMA. 1979 May 25;241(21):2298–2298. [PubMed]
  • Hines S, Houston M, Robertson D. The clinical spectrum of autonomic dysfunction. Am J Med. 1981 May;70(5):1091–1096. [PubMed]
  • Ewing DJ, Clarke BF. Diagnosis and management of diabetic autonomic neuropathy. Br Med J (Clin Res Ed) 1982 Oct 2;285(6346):916–918. [PMC free article] [PubMed]
  • Smith SA. 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. [PMC free article] [PubMed]
  • Ewing DJ, Campbell IW, Murray A, Neilson JM, Clarke BF. Immediate heart-rate response to standing: simple test for autonomic neuropathy in diabetes. Br Med J. 1978 Jan 21;1(6106):145–147. [PMC free article] [PubMed]
  • Collins KJ, Exton-Smith AN, James MH, Oliver DJ. Functional changes in autonomic nervous responses with ageing. Age Ageing. 1980 Feb;9(1):17–24. [PubMed]
  • Vargas E, Lye M. The assessment of autonomic function in the elderly. Age Ageing. 1980 Nov;9(4):210–214. [PubMed]
  • Baldwa VS, Ewing DJ. 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. [PMC free article] [PubMed]
  • Levin AB. 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. [PubMed]
  • Smith SE, Smith SA. Heart rate variability in healthy subjects measured with a bedside computer-based technique. Clin Sci (Lond) 1981 Oct;61(4):379–383. [PubMed]
  • Caird FI, Andrews GR, Kennedy RD. Effect of posture on blood pressure in the elderly. Br Heart J. 1973 May;35(5):527–530. [PMC free article] [PubMed]
  • Cudkowicz L. Normal, pharmacological and disordered systemic circulatory responses to the Valsalva manoeuvre. Respiration. 1968;25(2):81–115. [PubMed]

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